الفهرس 
Aim of the StudyOnly 14 pages are availabe for public view
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Abstract
There are different lines for treatment of Meniere’s disease including
diet and lifestyle modifications, non-invasive pressure pulse generator
(Meniett device), medications, pressure chamber treatment and surgical
treatment.
However, these lines of treatment are not preferred, except
medications, due to high incidence of side effects especially surgical
procedures as they are invasive lines which should only be used as the last
resort.
The success of a given treatment, medical or surgical, for Meniere’s
disease must always be evaluated by its ability to ameliorate vestibular
symptoms without affecting the cochlear component.
Thus intratympanic applications for treatment of Meniere’s disease
are evaluated as an alternative, less invasive line of treatment with better
results.
Intratympanic injection therapy of inner ear disease is safe,
inexpensive and easy to perform. High inner ear medication concentrations
can be achieved while minimizing systemic side effects. Most delivery
methods are minimally invasive and can be performed in the office. The
treatment is usually well accepted by patients. Vertigo control rates for
Meniere’s disease have been excellent in comparison with other ways of
treatment allowing intratympanic therapy to become one of the most
prominent line of treatment for Meniere’s disease.With intratympanic gentamycin injections, side effects of ototoxicity
occurring in approximately 30% of patients remain as one of the primary
hurdles to overcome. However, most patients who experience hearing loss
(non sreviceable hearing loss) do not complain of the loss and are simply
happy to be free of the vertigo attacks.
Intratympanic steroid injecyions were used initially for treatment of
sudden sensori-neural hearing loss then used for treatment of Meniere’s
disease. Steroid perfusion of the inner ear is variably effective for treatment
of sudden sensori-neural hearing loss and is particularly indicated when
oral steroid fail or are contraindicated due to other health reasons.
There are many inner ear perfusion methods. Each technique has its
associated advantages and disadvantages. The surgeon must decide which
technique to use in concordance with the patient’s disease and expectations.