**3. Results**

Initially, EMLA cream was applied (AstraZeneca, Wilmington DE) for topical anesthesia in the external auditory canal and the tympanic membrane and left for 30–45 minutes. Then, the patient's head was placed at 45° in the direction of the affected ear. A solution of 40 mg of methylprednisolone/ml was warmed to body temperature. About 0.3–0.5 ml of the solution was injected into the middle ear; two holes were made with the application of needle (Gelco N.22), one just below the umbo (where the drug was administered) and another in the upper

**Figure 1.** Schematic diagram.

178 Up to Date on Meniere's Disease

There were 23 subjects in the total, 13 subjects (6 female and 7 male, mean age = 38.30 years) in the oral steroid therapy (Group 1) and 10 subjects (7 female and 3 male, mean age = 47.40 years) in the intratympanic corticosteroids after failure of oral therapy (Group 2).

The average total score in THI before in Group 1 (*n* = 13) was 64.77 points, and after oral therapy, it was 45.90 points. The mean of the THI score before intratympanic corticosteroids after failure of oral therapy (Group 2) (*n* = 10) was 72.20 points and 47.73 points after (**Figure 2**). The mean VAS value in Group 1 was 7.69 points before and 5.30 points after therapy. The average value in VAS for the Group 2 was 8.30 points before and 5.81 points after therapy (**Figure 3**). THI and VAS averages showed a significant decrease when comparing the values before and after treatment intragroups (*p* < 0.05), whereas the analysis between groups was not statistically different.

In pure tone audiometry, we found the average of 74.23 dB (Group 1) before and 59.69 dB after therapy and 86.50 dB before and 51.91 dB after therapy (Group 2; **Figure 4**). A significant decrease in pure tone thresholds was found when comparing the values before and after treatment intragroups (*p* < 0.05), whereas the analysis between groups was not statistically different.

**Figure 2.** THI results before and after treatment.

**Figure 3.** VAS results before and after treatment.

**Figure 4.** PTA results before and after treatment.

In the DPOAE test, we found in Group 1 the following amplitude values before and after therapy: for frequencies of 2 KHz: −10.08 and −1.69 dB; 3 KHz: −9.77 and −1.85 dB; 4 KHz: −10.92 and −5.08 dB; and 5 KHz: −10.69 and −2.85 dB. As for Group 2, the following amplitude values were obtained before and after treatment, respectively: 2 KHz: −12.30 and −3.90 dB; 3 KHz: −12.00 and −7.10 dB; 4 KHz: −11.30 and −6.10 dB, and 5 KHz: −12.60 and −4.40 dB (**Figure 5**).

As for the S/N ratio, the following values were obtained in Group 1 before and after therapy, for each frequency tested: 2 KHz: 2.77 and 8.38 dB; 3 KHz: 2.23 and 8.69; 4 KHz: 0.00 and 7.85 dB, and 5 KHz: 1.23 and 8.08 dB (**Figure 6**). We found a significant decrease when comparing the amplitude values before and after treatment intragroups (*p* < 0.05) in the four analyzed frequencies (2, 3, 4, and 5 KHz), while the analysis between groups did not show statistical difference.

The S/N ratios were as follows before and after treatment, respectively: 2 KHz: 0.00 and 7.10 dB; 3 KHz: 0.50 and 7.10 dB; 4 KHz: 1.00 and 4.30 dB, and 5 KHz: −0.70 and 4.50 dB (**Figure 6**). There was decrease when comparing signal/noise values before and after treatment intragroups (*p* < 0.05) in four analyzed frequencies (2 and 5 KHz), while the analysis between groups was not statistically different.

**Figure 5.** Amplitude results before and after treatment.

**Figure 6.** Signal/noise results before and after treatment.

**Figure 4.** PTA results before and after treatment.

**Figure 2.** THI results before and after treatment.

180 Up to Date on Meniere's Disease

**Figure 3.** VAS results before and after treatment.
