INTRATYMPANIC THERAPIES FOR INNER EAR DISORDERS 

Otorinolaringologia 2010 September;60(3):155-63

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Intratympanic management for autoimmune inner ear disease

De Stefano A., Kulamarva G., Dispenza F.

¹ ENT Institute, Department of Surgical, Clinical and Experimental Sciences, “G.d’Annunzio” University of Chieti and Pescara Chieti, Italy 2 ENT Clinic, Nayak’s Road, Kasaragod, Kerala, India 3 Department of Surgical and Oncological Disciplines, University of Palermo, Palermo, Italy

Autoimmune inner ear disease (AIED) is a rare condition that accounts for less than 1% of hearing loss or dizziness. Patients generally have aural fullness as well as tinnitus which may precede the hearing loss. One ear is usually involved first and worsens ahead of the contralateral side. Therefore patients may have only unilateral involvement on initial presentation. A spontaneous improvement or resolution of untreated hearing loss in patients affected by AIED does not often occur. For this reason when an AIED is suspected prompt management should be established in order to stop the steady deterioration of hearing function. Intratympanic management of AIED with methylpredinosolone or and recently with Infliximab has been shown to be safe, easy and useful in the therapy of refractory immune-mediated inner ear disease. For all the above reasons management of AIED with intratympanic steroids may be recommended as the first line of treatment for these patients, while in the near future transtympanic management with TNF-α antibody is likely to come into the fore.