Efficacy Of Intratympanic Injection Of Dexamethasone For Treatment Of Meniere’s Disease And Analysis Of Vestibular Function

Objective:To observe the efficacy of intratympanic injection of dexamethasone for treatment of Meniere’s disease,compare the treatment effects of different clinical stages of Meniere’s disease,analyze the characteristics of vestibular function in patients with Meniere’s disease of different stages,and aim to evaluate the stages of Meniere’s disease more comprehensively,Looking for more effective treatment options.Methods:To retrospectively analyze the clinical data and treatment effects of 88 Meniere’s disease patients in our hospital from August 2017 to September 2019,and the patients were divided into tympanic group(receiving intratympanic injection of dexamethasone and medical treatment)and internal medicine group(receiving medical treatment)according to different treatment methods,compare the hearing and vertigo control efficacy between the two groups,and evaluate the effect of repeated treatment of patients in the tympanum group and compare the improvement of pure tone hearing threshold at different visit times,and compare the treatment effects of patients in the tympanum group at different clinical stages.After the vestibular symptoms were relieved,caloric tests,cervical muscle vestibular evoked myogenic potentials(c VEMP),and ocular muscle vestibular evoked myogenic potentials(o VEMP)were performed on all patients to analyze the characteristics of vestibular function in patients with Meniere’s disease at different stages,and explore the relationship between the clinical stages of Meniere’s disease and the grades of vestibular functionResults:The total control rate of vertigo(Grade A)and the uncontrolled rate(Grade D)were compared between the tympanum group and the internal medicine group.The difference was statistically significant(P<0.05).The basic control rate of vertigo(Grade B)and the partial control rate of vertigo(C Grade)there was no statistically significant difference between the two treatment plans(P>0.05).The total control rate of the tympanum group was 96.8%,and the total control rate of the medical treatment group was 76.9%.The difference between the two groups was statistically significant(P<0.05).There was no statistically significant difference in the improvement of pure tone hearing threshold and pure tone hearing threshold after treatment between the two treatment programs(P>0.05).After the second ITD treatment,39 cases(62.9%)of vertigo were controlled to grade A,10 cases(16.1%)of grade B,11 cases of grade C(17.7%),and 2 cases of grade D(3.2%).There was no significant difference in the rate of complete control of vertigo and the rate of total control of vertigo in patients with Meniere’s disease who received dexamethasone injection in the tympanum between mild(Ⅰ+Ⅱ)and severe(Ⅲ+Ⅳ)patients(P>0.05).The hearing improvement value of Meniere’s disease patients who received ITD treatment within 2 weeks during this visit was significantly different from that of patients treated 2weeks later(P<0.05).There was no significant difference in the elicitation rate of VEMPs in Meniere’s disease patients of different stages(P>0.05),the difference in the abnormal rate of c VEMP was statistically significant,and the difference in the abnormal rate of o VEMP and cold and heat tests was not statistically significant(P>0.05).The progression of Meniere’s disease stage was positively correlated with the rate of vestibular dysfunction(r=0.231,P=0.030).Conclusion:1.Intratympanic injection of dexamethasone can effectively control the onset of vertigo in patients with Meniere’s disease,and has a protective effect on hearing.It is an effective drug to prevent the progression of Meniere’s disease hearing loss.2.For patients with unsatisfactory initial treatment effect of dexamethasone injection into the tympanum,repeated intratympanic injection of dexamethasone can be performed.Intratympanic injection of dexamethasone has similar efficacy in controlling vertigo in Meniere’s disease patients with different degrees of hearing loss.Therefore,intratympanic injection of dexamethasone can be used for treatment regardless of the degree of hearing loss.Patients with Meniere’s disease who have new hearing loss are advised to receive dexamethasone injection into the tympanic cavity as soon as possible to improve hearing.3.With the progress of clinical staging,the abnormal rate of o VEMP,c VEMP,and cold and heat tests has increased.A comprehensive assessment of the vestibular function of patients with Meniere’s disease is conducive to the formulation of precise treatment plans.