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