Middle Ear Chemical Perfusion for Tinnitus or Vertigo

Dr. Love has recently attended an international meeting where results of several inner ear research studies were shared. From these studies, many physicians, Dr. Love included, have begun to treat difficult inner ear problems with new techniques.

For Benign Paroxysmal Positional Vertigo, Dr. Love has begun to prescribe the Canalith repositioning maneuver or Epley maneuver as it was described by one of Dr. Love's colleagues from Portland, Dr. John Epley. This treatment, combined with strengthening exercises, has helped many patients achieve rapid relief from disabling vertigo.

For Vertigo from Meniere's syndrome or from Endolymphatic Hydrops, Dr. Love has begun to recommend initial treatment with oral steroid medications. For those with some incomplete relief, middle ear chemical perfusion with steroid or antibiotic medications are infused through a tube placed in the eardrum. The Tympanostomy, or tube placement, can be performed in the office under local anesthesia for some patients. For others, brief intravenous sedation in the operating room at the hospital can allow tube placement in a pain free method.

Some patients have achieved dramatic relief with initial treatment. Others have required frequent dosing to gain improvement in balance or improved relief from tinnitus.

Direct infusion of medications into the middle ear, especially those medications once thought to be ototoxic, can yield unpredictable results. Special hearing testing to measure inner ear function may need to be performed on a frequent basis during a treatment schedule to detect quickly any changes in hearing function.

Oral medications, especially steroids, can cause other side effects. Elevated blood sugars for diabetics is a problem which may not allow oral steroids to be used. Direct infusion of steroid into the middle ear does not seem to create the same problem with blood sugars.

Many patients may notice a transient elevation in weight when taking steroids. Some patients notice an abrupt attitude while on these medications as well. Those who are poorly tolerant of oral steroid medications may have no problems with middle ear steroid perfusion.

Dr. Love usually asks that a brief trial of medium dose steroids be used before attempting middle ear chemical perfusion. Placement of a tympanostomy tube in the ear makes repeat infusion treatments much less painful and much easier for the patient.

Our office will continue to update you on new techniques for the treatment of inner ear abnormalities. We will also be happy to answer any questions which you might have and would welcome your comments.

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