Effect of intratympanic steroid injection in light cupula

• Published in: Acta oto-laryngologica Vol. 138; no. 9; pp. 769 - 774
• Main Authors: Park, Jin Su, Kim, So Yean, Kim, Min-Beom
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02.09.2018
• Subjects: Benign Paroxysmal Positional Vertigo - complications; Benign Paroxysmal Positional Vertigo - drug therapy; canalith repositioning procedure; Cochlea - pathology; direction-changing positional nystagmus; Female; Humans; Injection, Intratympanic; intratympanic steroid injection; Light cupula; Male; Middle Aged; Nystagmus, Pathologic - complications; Nystagmus, Pathologic - diagnosis; Nystagmus, Pathologic - drug therapy; Patient Positioning; Prospective Studies; Semicircular Canals; Steroids - administration & dosage; Vestibular Function Tests; Vestibule, Labyrinth - physiopathology; Visual Analog Scale; intratympanic steroid injection; canalith repositioning procedure; direction-changing positional nystagmus; Light cupula
• ISSN: 0001-6489; 1651-2251
• DOI: 10.1080/00016489.2018.1467135

Objective: To evaluate the effects of intratympanic steroid injection (ITS) in light cupula. Methods: A total of 47 patients showing persistent geotropic direction-changing positional nystagmus with null point (light cupula) were randomly classified into three groups: ITS (n = 15), vestibular suppressant (VS, n = 16) and canalith repositioning procedure (CRP, n = 16). Positional nystagmus and dizziness severity by dizziness handicap inventory (DHI) and visual analogue scale (VAS) were conducted before and 3 d and 1 week after first treatment to compare the effect of each treatment. Results: DHI and VAS scores had decreased after each treatment; however, there were no differences among the three groups. A week after the first treatment, 7, 6 and 7 patients showed resolution of direction-changing positional nystagmus (DCPN) in the ITS, CRP and VS groups, respectively. There were no significant differences between the three groups. In the ITS group only, however, reversal of the stronger side on head roll test was observed in 6 patients, and 2 of them showed resolution of DCPN at the third day. Conclusions: ITS was not effective for patients with light cupula at 1-week follow-up. However, some patients in the ITS group showed resolution of DCPN at earlier follow-up.