The Physiologic Role of Corticosteroids in Ménière's Disease: An Update on Glucocorticoid-mediated Pathophysiology and Corticosteroid Inner Ear Distribution: There are multiple treatment options for Ménière's disease (MD), including dietary modifications, aminoglycoside therapy, and surgery. All have limitations, ranging from limited effectiveness to permanent hearing loss. Corticosteroids have long been used to manage MD due to their relative efficacy and tolerability, but the exact mechanism for disease alleviation is uncertain. Until recently, the precise distribution and role that glucocorticoid receptors play in inner ear diseases have remained largely uninvestigated. Several studies propose they influence mechanisms of fluid regulation through ion and water homeostasis. This review will provide an update on the basic science literature describing the activity of endogenous glucocorticoids and exogenous corticosteroids in the inner ear and the relevance to MD, as well as early clinical trial data pertaining to the application of novel technologies for more effective administration of corticosteroids for the treatment of MD.
Address correspondence and reprint requests to Michael H. Froehlich, 135 Rutledge Ave, Rutledge Tower, 10th Floor, Charleston, SC 29425; E-mail: froehlim@musc.edu, michaelh.froehlich@gmail.com
Dr. Lambert, through his position as the Chair of the Department of Otolaryngology–Head and Neck Surgery at the Medical University of South Carolina, has a financial relationship with Otonomy, outside of the submitted work. He served as principal investigation of three clinical trials investigating intratympanic injection of an Otonomy hydrogel poloxamer for the treatment of Ménière's disease. Mr. Froehlich has no conflicts of interests to declare. This manuscript was unfunded.
Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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