This article reviews the effectiveness of intratympanic corticosteroids for vertigo control in Meniere's disease at 2-years follow-up according to the guidelines expressed by the American Academy of Otolaryngology...This article reviews the effectiveness of intratympanic corticosteroids for vertigo control in Meniere's disease at 2-years follow-up according to the guidelines expressed by the American Academy of Otolaryngology-Head & Neck Surgery. Despite the increased use of intratympanic corticosteroids for vertigo control in Meniere's disease there is debate as to their effectiveness, particularly compared to gentamicin. Even so,after just a single course of injections, corticosteroids can reliably provide complete vertigo control(Class A) at 2-years in about 50% of cases as indicated in a recent double-blind randomized controlled clinical trial(Patel et al., 2016). But the effectiveness of intratympanic corticosteroids truly increases when treatment is provided 'as-needed', whereby complete vertigo control is established in up to 91% of cases. On the basis of available literature, there is good evidence to recommend the use of intratympanic steroid treatment for vertigo control in Meniere's disease, but patients must be monitored for non-response. The rationale for treating patients as-needed and the possible reasons for corticosteroid nonresponse are discussed.展开更多
The Standard Model(SM)of particle physics succeeds in predicting the vast majority of experimental high-energy data in terms of a minimal set of subatomic particles and their strong and electroweak interactions.Howeve...The Standard Model(SM)of particle physics succeeds in predicting the vast majority of experimental high-energy data in terms of a minimal set of subatomic particles and their strong and electroweak interactions.However,while it is a selfconsistent theory.展开更多
基金supported by the National Institute for Health Research(NIHR)Imperial Biomedical Research Centre
文摘This article reviews the effectiveness of intratympanic corticosteroids for vertigo control in Meniere's disease at 2-years follow-up according to the guidelines expressed by the American Academy of Otolaryngology-Head & Neck Surgery. Despite the increased use of intratympanic corticosteroids for vertigo control in Meniere's disease there is debate as to their effectiveness, particularly compared to gentamicin. Even so,after just a single course of injections, corticosteroids can reliably provide complete vertigo control(Class A) at 2-years in about 50% of cases as indicated in a recent double-blind randomized controlled clinical trial(Patel et al., 2016). But the effectiveness of intratympanic corticosteroids truly increases when treatment is provided 'as-needed', whereby complete vertigo control is established in up to 91% of cases. On the basis of available literature, there is good evidence to recommend the use of intratympanic steroid treatment for vertigo control in Meniere's disease, but patients must be monitored for non-response. The rationale for treating patients as-needed and the possible reasons for corticosteroid nonresponse are discussed.
基金support from the Spanish MINECO through the“Ramón y Cajal”Program RYC-2016–20672 and the PGC2018-102016-A-I00support from the UK Science and Technology Facilities Council(STFC)。
文摘The Standard Model(SM)of particle physics succeeds in predicting the vast majority of experimental high-energy data in terms of a minimal set of subatomic particles and their strong and electroweak interactions.However,while it is a selfconsistent theory.
