Gendi Yin

and 8 more

Objectives: To study the complications of intratymapanic dexamethasone for Méniere’s disease. Study Design:a randomized controlled trial. Methods:124 patients with Méniere’s disease were randomly divided into two groups: Intratympanic dexamethasone(ITD) group (n=62) and Intratympanic lidocaine(ITL) group (n=62). According to the dose of dexamethasone used during treatment, the patients in ITD group were further divided intoITD1(2mg/ml) group (n=31) and ITD2(5mg/ml) group (n=31).The complications in each group were observed and evaluated after 10 times of intratympanic treatment with ear endoscopy. Results:3 patients suffered from the external auditory canal mycosis after ITD therapy. All the 3 patients were in the ITD2 group and the the infectious rate between patients who used 5mg/ml of dexamethasone and those who used 2mg/ml exhibited significant statistical difference. There were 5 cases of tympanic membrane atrophy thinning in ITD group , while no tympanic membrane atrophy thinning was observed in ITL group, the incidence rate between these two groups showed significant statistical difference. In addition, two patients in the ITD group had perforation accompanied by external auditory meatus mycosis, while no tympanic membrane perforation was observed in the ITL group. There was no statistical difference in the incidence of vertigo, pain, tongue numbness, tinnitus and other complications between the two groups. Conclusions: Our study suggests that the occurrence of external auditory canal mycosis and tympanic membrane atrophy thinning were significantly correlated with the use of dexamethasone and the occurrence of external auditory canal mycosis was closely related to the drug concentration, while the occurrence of tympanic membrane atrophy thinning showed not significantly correlated with the drug concentration. Further understanding of the clinical characteristics of complications after ITD will help clinicians select the appropriate concentration of dexamethasone in the therapy and better manage these complications.