Intratympanic Lidocaine as means of non-ablative therapy of Ménière's Disease
23 April 2019 (online)
Ménière's Disease (MD) is a chronic condition, that causes considerable distress to those affected with it. Until recently, standard therapy consisted of oral administration of betahistine. However, the BEMED-study raised considerable doubts about the effectiveness of this therapy regiment. We therefore conducted a retrospective analysis of patients that had been treated with intratympanic Lidocaine for MD.
Overall, patient files of 20 patients that had a definite MD (according to the criteria set by the barany society 2016) were included in the study. These patients received a total of 34 injections of lidocaine. We used the patient files to collect data on the subjective benefit, the number of attacks before and after the injection, the time until the next episode of MD and hearing levels before and after injections.
The average age of patients at the time of the first injection was 55.2 years. The men to women ratio was 15: 5 and both sides (left/right) were equally often affected. 18 of the 20 patients reported a considerable increase in wellbeing or even being attack free after the initial injections. The mean number of attacks per month decreased from 7.1 to 1.9 episodes/month. The average time until the next episode of MD took place was 237.1 days. In 14 patients, hearing remeined unchanged, while 5 patients showed a slight decrease in hearing levels and no hearing data was available for one patient.
This retrospective dataset suggests a good efficacy and safety of intratympanic lidocaine for MD. Thus, intratympanic lidocaine seems like a valid option in the therapy of MD that can already be applied clinically but also should be investigated further to create a stronger scientific foundation for its use.