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Background: Meniere?s syndrome or disease (MS/D) is typically characterized by episodic vertigo, aural fullness, tinnitus and
fluctuating hearing loss. There are multiple options available for treatment with variation in consensus on the best intervention.
Objective: To evaluate the evidence on the efficacy of intratympanic therapies [steroids, gentamicin, antiviral therapy and
other therapies] on the frequency and severity of vertigo and other symptoms of MS/D Search strategy: A literature search was
performed on amed, embase, hmic, medline, psycinfo, bni, cinahl, health business elite, central and Cochrane Ear, Nose and
Throat disorders group trials register using various MeSH. The search was restricted to English and human subjects and the
last date of search was Dec 2014
Selection Criteria: Randomized controlled trials of intratympanic therapies [steroids, gentamicin and antiviral agents,
latanoprost] versus a placebo or another treatment.
Results: 8 RCT?s were analyzed comparing intratympanic steroids, gentamicin, Ganciclovir (antiviral) and latanoprost versus
another form of intratympanic treatment or placebo.
Conclusions: On the basis of 6 RCT?s (n=242) there is evidence to support the effectiveness of intratympanic steroids and
gentamicin to control symptoms of vertigo in MS/D albeit with a risk of hearing loss in gentamicin. However, there was no
consensus found on doses or treatment protocols. There was no evidence for the use of other forms of intratympanic therapy
(antivirals and latanoprost) in MS/D
Biography
Mohammed Iqbal Syed completed his MBBS and a Master?s degree in Otolaryngology from the Pune University in India. He completed his specialist training (DLO
and FRCS) from the United Kingdom and was awarded a travelling fellowship to the University Hospital in Zurich and the TWJ clinical fellowship in Otology/Skull
base surgery at the University of Toronto. He has published over 25 peer reviewed papers and presently is a Consultant in Otology and Skull base surgery at the
Royal Infirmary/Western Infirmary in Edinburgh.
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