Intratympanic steroid injections safe and effective for refractory Meniere's disease,finds study

Results highlighted some key facts.

• Five studies involving 332 patients with refractory unilateral Meniere's disease were included. In the pooled analysis, those treated with ITGI showed higher ORs than those treated with ITSI in terms of vertigo control rate (OR: 2.39, 95% CI: 0.84–6.79, P = 0.102) and spell counts (SMD: 0.24, 95% CI: −0.12–0.59, P = 0.195), but it did not reach statistical significance.
• However, a substantial amount of heterogeneity (I2 = 71.0%, Q = 13.79, P = 0.008) and publication bias was found, suggesting a significant small-study effect. Additionally, ITSI elicited better hearing outcomes of the mean PTA threshold (SMD: 3.08, 95% CI: −1.18–7.35) and mean SDS (SMD: 11.15, 95% CI: −23.21–0.90) compared with ITGI, although no statistical significance. In subgroup analysis, the difference in vertigo control rate between ITGI and ITSI was not significant, regardless of the follow-up period and steroid type.
• Further, methylprednisolone appeared to be superior to dexamethasone for vertigo control.
• No significant complications from either treatment were reported in the literature.

"The results of this study further refine the recently proposed efficacy of ITSI for the treatment of refractory Meniere's disease,. Collectively, However, the current evidence on efficacy of ITSI for refractory Meniere's disease needs to be further clarified, given the substantial heterogeneity and potential biases."the team concluded.

For full article follow the link: https://doi.org/10.1016/j.amjoto.2021.103086

Source: American Journal of Otolaryngology