Mahmut Tayyar KALCİOGLU, Tuba BAYİNDİR, Ali OZERK, Yuksel TOPLU, Osman Ilkay OZDAMAR

Meniere hastalığında vertigo kontrolünde intra timpanik deksametazon kullanımı ile ilgili tecrübelerimiz

Amaç: Ménière hastalığı vertigo ve denge bozukluğu ataklarını takiben yeni bir vertigo atağına kadar nispeten normal dengenin olduğu bir hastalık olarak açıklanmaktadır. Bu atakların sıklığı hastadan hastaya olduğu kadar, hastanın bizzat kendisinde de farklı derecelerde değişiklik gösterir. Literatürde bu hastalığın tedavisinde intratimpanik kortikosteroid enjeksiyonu tedavisi ile ilgili çalışmalar mevcut olmasına rağmen, bu konuyla ilgili olarak bu minimal invazif tedavinin uzun dönem faydası belirsizdir. Bu çalışmada Ménière hastalarına intratimpanik dexamethasone kullanımının uzun dönem sonuçlarını tetkik etmeyi amaçladık. Gereç ve Yöntemler: Ménière hastalığına bağlı olarak vertigo şikayeti olan 11 hastanın değerlendirildiği bu retrospektif çalışma bir üçüncü basamak sağlık merkezinde yapılmıştır. Bu hastalarda, hasta olan kulağa intratimpanik dexamethasone enjeksiyonu uygulanmıştır. Tedavi öncesi 6 aylık dönemdeki vertigo ataklarının sayısı ile tedavi sonrası 18. ve 24. aylar arasındaki 6 aylık dönemdeki vertigo atakları sayısı arasındaki oran (Amerika İşitme ve Denge Komitesinin normlarına göre, 1995) değerlendirilmiştir. Bulgular: Bütün hastalarda belirgin iyileşme elde edildi. Hastalardan birinde 1 yıl sonra tedavi tekrar edildi. Sonuç: Literatür ile benzer olarak, intratimpanik dexamethasone kullanımı daha invazif tedavi yöntemlerinde bir önceki basamak olarak veya bunlardan kaçınmak için Ménière hastalığına bağlı vertigonun kontrolünde faydalı olabileceğini göstermektedir.

Our experiences on intratympanic dexamethasone usage to vertigo control in ménière disease

Objective: Ménière disease is a disorder defined with vertigo and disequilibrium attacks and followed by a considerable normal equilibrium until to the next vertigo attack. The frequency of these attacks changes not only patient to patient but also in particular patient himself/herself in varying degree. Although there are studies about intratympanic corticosteroid injection treatment for the disease in the literature, the long-term efficacy of this minimally invasive treatment modality is obscure regarding with this issue. In this study, we aimed to verify long-term results in the use of intratympanic dexamethasone in patients with Ménière disease. Materials and Methods: This is a retrospective study that was performed in a tertiary referral center in which eleven patients with vertigo due to Ménière disease were evaluated. Intratympanic dexamethasone was infiltrated to diseased ear of these patients. The ratio between the number of vertigo episodes in the 6 months prior to treatment and the number of episodes in the six months between the 18th and 24th month after treatment (according to the norms of the American committee for the hearing and the equilibrium, 1995) were examined. Results: All patients improved significantly. Treatment was repeated after one year in one of the patients. Conclusion: Similarly with the published literature, the use of intratympanic dexamethasone may be useful to control vertigo due to Ménière disease to avoid or to be a prior step to other more invasive treatments.

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