Intratympanic Steroids in Ménière's Disease: Impact on Vertigo, Hearing, and Quality of Life

Background: Ménière’s disease (MD) is an audiovestibular debilitating condition characterized by episodic vertigo, variable degrees of hearing loss, tinnitus, and aural fullness. Objective: To evaluate the efficacy of intratympanic steroid therapy in combination with standard treatment compared to standard therapy alone on managing signs of MD. Patients and methods: Eighty patients diagnosed with MD were randomly allocated into one of the treatment groups. Patients of group A received standard therapy (betahistine, low-salt diet, and diuretics), while patients of group B received standard therapy in addition to intratympanic steroid injections (dexamethasone 4 mg/mL). Vertigo severity (Dizziness Handicap Inventory (DHI) score), hearing stability (Pure-tone audiometry (PTA) score), and quality of life were assessed at the time of patient recruitment and at three and six months post treatment. Results: The study revealed significant improvements in patients of group B compared to patients in group A. Group B showed greater reductions in DHI scores and better hearing stability (PTA scores) at three and six months post-treatment (p < 0.001). Quality of life scores also improved significantly in Group B (p < 0.001). Linear regression analysis showed significant effects of treatment on all outcomes. For vertigo, Group B showed a beta of -0.26 (p = 0.021), for hearing stability, a beta of -0.45 (p < 0.001), and for quality of life, a beta of -0.30 (p = 0.007). These results underline the enhanced efficacy of intratympanic steroids in improving patient outcomes at the end of the follow-up period. Conclusion: Intratympanic steroids combined with standard therapy significantly manage signs of MD compared to standard therapy alone. These findings support the clinical application of intratympanic steroids as an effective adjunctive treatment for optimizing patient outcomes.