Ed's Meniere's Disease Video 6.3: Steroids

Steroids are probably one of the more controversial medications for Meneire's because it many studies, there is unclear benefit. HOWEVER, there are circumstances where they definitely could benefit: 1) if the inner ear is "inflamed" for any reason. 2) if the underlying etiology of a person's individual Meneire's is cause by auto-immune disease. 3) Suppression of allergies and histamine release that exacerbate Meneire's. Steroids are naturally produced hormones from the Adrenal gland (just above the kidneys) that regulate the metabolism and function of ALL CELLS. Prednisone -- most common oral steroid -- 1mg to 60mg tablets Prednisolone (Break down of Predinisone) - More used in pediatric patients Decadron -- Very Potent anti- inflammatory steroid -- use more for Brain trauma. Also INJECTED in the Middle Ear. Cortisol / Cortisone -- more "Mineral corticoid" function Triamcinolone (Kenalog) -- used for Injections Fluticasone (Flonase) Nasal Spray Hydrocortisone 1% Cream Authors number patients treated Protocol response Comment Silverstein et al. (1998). " 20 3 injections in 3 days None Short duration Hirvonen, et al, 2000 17 3 injections over 1 week 76% control of vertigo , no response of hearing Short duration Barrs, et al. (2001). 21 2 injections in 2 weeks 43% response at 6 mo (similar to placebo) Short duration Sennaroglu et al. 2001 24 drops instilled every other day for 3 months 72% relief of vertigo, no response of hearing or tinnitus Long duration Arriaga et al ...