Intratympanal administration of lidocaine in the management of Meniere's Disease

Background Meniere's Disease (MD) is a chronic condition where patients suffer recurrent vertigo attacks. Evidence for treatment concepts are to this date low. Aims/objective To evaluate the therapeutic effect of intratympanic lidocaine injections to reduce the number of attacks. Methods Twenty patients diagnosed with definitive MD that were treated with 34 intratympanic lidocaine injections were included. Main outcome measures were the number of vertigo attacks in the previous four weeks, the attack free period and the subjective improvement of the condition. Results Mean follow up after first lidocaine injection was 25.3 months (+/- 22.2; range 1.9-79.7). Patients expressed subjective improvement in overall situation, vertigo, and aural fullness. The number of vertigo attacks before each assessment decreased from 7.1 (+/- 5.9; range 2-20) per months at baseline to 1.9 (+/- 3.8; range 0-15). 25% of the patients suffered no further attacks, the other patients had an average attack free period of 7.8 months (+/- 15.4; range 0.2-58.4). Hearing thresholds remained unaffected. Repetitive injections proved effective. Conclusion and significance Intratympanic lidocaine is an effective nonsurgical and non-ablative therapy for MD. When patients experience an increase of attacks repetitive injections promise improvement.