Effect of intratympanic steroid injection in light cupula

Abstract

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.

Chinese abstract

目的：评价鼓室内对轻耳蜗顶注射类固醇激素（ITS）的作用。

方法：将47例患有带麻点（轻耳蜗顶）的顽固性变向性位置性眼球震颤的患者随机分为3组：ITS（n = 15）、前庭抑制剂（VS, n = 16）和耳石复位手术（CRP, n = 16）。在第一次治疗之前和之后第三天和第一周, 根据头晕障碍清单（DHI）和视觉模拟评分（VAS）确定位置性眼球震颤和头晕严重性, 以比较每种治疗的效果。

结果：每次治疗后DHI和VAS评分均下降;然而, 在三组之间没有差异。第一次治疗一周后, 在ITS、CRP和VS组中分别有7、6和7名患者表现出变向性位置性眼球震颤（DCPN）的分辨率。三组之间没有显着差异。然而, 只有在ITS组中, 6名患者在头部转动测试中观察到较强侧的逆转, 其中2名在第三天显示DCPN的分辨率。

结论：在1周随访期间, ITS对轻耳蜗顶患者无效。然而, ITS组中的一些患者在早期随访中显示DCPN的分辨率。

Keywords:

• Light cupula
• direction-changing positional nystagmus
• intratympanic steroid injection
• canalith repositioning procedure

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Medical Research Funds from Kangbuk Samsung Hospital.