Curative Effect Analysis Of Intratympanic Injection With Dexamethasone And High Dosage Of Betahistine In The Treatment Of Intractable Unilateral Meniere’s Disease

Objective To analiyze and compare the curative effect,consisting of Vertigo control and preserving hearing,of intratympanic(IT)injection with dexamethasone and high dosage of betahistine(BT)in the treatment of patients who were diagnosed with intractable unilateral Meniere’s disease(MD).Materials and methods Reference to the diagnosis and treatment criteria of Meniere’s disease issued by the Chinese Medical Association of Otolaryngology Head and Neck Surgery in 2017,and judging by no curative effect with conventional medical treatments,for example,adjusting lifestyle(consists of low-salt diet,refraining from caffeine、tobacco、alcohol intake,etc),diuretics,vasodilator,nourishing nerve,vestibular rehabilitation training,etc,53 patients with invalid Meniere’s disease were randomly divided into group DX(26 cases)and group BT(27 cases).Group DX received the intratympanic injections with dexamethasone:each time 1mL(5g/L),once every 3 days,a total of 3 times,the total dose was 15mg,while Group BT received a high-dosage of betahistine:entailed 72 mg/day(24mg tid).During the study period,all the patients were surveyed in the clinic every two months for up to 1 year.Learning the side-effects and compliance to treatment were checked through telephone calls.Mean outcome measures consisted of vertigo control,Dizziness Handicap Inventory(DHI)-Chinese version,pure tone average(PTA).Results 5 patients withdrew from the experimental research due to poor compliance treatment,including 2 cases in group DX and 3 in group BT.The clinical data of 48 patients with better compliance were collected,and the results were as follows:1.Vertigo control:In Group DX,complete vertigo control(class A)was attained in 11 patients(45.8%)and substantial control(class B)in 6 patients(25.0%).In Group BT,10 patients(41.7%)achieved complete vertigo control(class A),4 patients(16.7%)substantial control(class B).There is no statistical difference in vertigo control between the two treatment groups.2.Living quality:According to the Dizziness Handicap Inventory(DHI)-Chinese version,judging the curative effect.In Group DX,the DHI before treatment is 52.9(52.9±6.8),and the DHI after treatment is 42.8(42.8±10.9);In Group BT,the DHI before treatment is 52.5(52.5±7.3),and the DHI after treatment is 41.3(41.3±10.6).There is no statistical difference in Living quality(DHI)between the two treatment groups.3.Hearing protection:In Group DX,hearing was improved in 3 patients and unchanged in 11 patients,while in Group BT,hearing was improved in 2 patients and unchanged in 13 patients.Before and after the treatment,the pure-tone average of group DX were 57.9(57.9±6.7)dB and 55.0(55.0±11.6)dB,while the the pure-tonr average of group BT were 57.1(57.1 ± 8.4)dB and 54.6(54.6 ± 9.9)dB.There is also no statistical difference in hearing protection in the same group and with the other group.Conclusions Our preliminary results demonstrate that,high dosage of betahistine achieved similar outcomes as intratympanic injections with dexamethasone in the control of vertigo,but dexamethasone takes effect more rapidly.On the othe hand,two therapeutic methods achieved similar outcomes scarcely in hearing preservation.