Volume 20 No 12 (2022)
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Intratympanic Perfusion for Treatment of Meniere's Disease
Mohamed Abdelmohsen Alnemr, Amira Selem Abdelazem Selem, Ezzeddin Mohamed Elshiekh, and Alaa Eldin Mohamed Elfeky
Ménière’s disease, defined by Prosper Ménière at the beginning of 19th Century, is a syndromic inner ear disease which is commonly associated with a pathological accumulation of endolymphatic fluid in the inner ear "idiopathic endolymphatic hydrops”.Endolymphatic hydrops (EH) seems to be due to an overproduction of endolymph and/or a decrease in the absorption of endolymph. Endolymphatic pressure variations may result from alterations in secretion, osmosis, and resorption.EH is a pathological condition in which there is a distention of the scala media by enlargement of endolymphatic volume (19) with ballooning of Reissner's membrane into the scala vestibule from its flat configuration due to endolymphatic pressure elevations. Induced tension can return the membrane to its normal position if the displacement is mild and the pressure is physiological and transient.When first-line treatment does not offer a satisfactory symptoms control, especially for vertigo, more invasive treatments (the second line) must be considered. The second line is the intratympanic injections, mainly intratympanic steroid (ITS) as a conservative treatment and intratympanic gentamicin (ITG) as a destructive treatment. After this second line, 90 to 95% of the patients are cured or in remission.
Intratympanic Perfusion, Meniere's Disease
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