Intratympanic dexamethasone and hyaluronic acid in patients with low-frequency and Meniere's-associated sudden sensorineural hearing loss

Background: Steroids are widely used for the treatment of cochleovestibular disorders. Direct steroid application in the middle ear cavity, when combined with a round window membrane permeability-modulating substance, increases the level of the steroid reaching the target cells. We measured hearing in patients with idiopathic isolated low-frequency sensorineural hearing loss and in patients with sudden sensorineural hearing loss and a history of Meniere's disease. Contradictory reports about effectiveness of intratympanic steroid therapy on vertigo control and hearing improvement in patients with Meniere's disease exist in the literature

Selective chemical vestibulectomy: Preliminary results with human application

The involved membranous labyrinth of patients with medically intractable Meniere's disease is being accessed by means of a fenestration of the bony horizontal semicircular canal in preparation for the application of a 125 or 250 mcg flake of solid streptomycin. Sensory information originating in the affected vestibular end organ is selectively blocked from reaching the central nervous system. This uniformly results in the rapid elimination of vertiginous symptoms, and at these calculated doses yields preservation of (or in some cases improvement in) preoperative cochlear thresholds. The rationale for this procedure, as detailed in earlier investigations of animals, will be briefly reviewed before highlighting our preliminary results in adult clinical trials