Evidence map›Paper›PMID 40615707›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025

Dual-target corticosteroid therapy for refractory Ménière's disease: influence of vestibular aqueduct patency and endotypes.

Jing Zou, Hongbin Li, Minhui Zhu, Guoping Zhang, Yingna Gao, Tianhao Lu, Antti Arnisalo, Ilmari Pyykkö

Abstract readClinical Study
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In one paragraph

Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Jing ZouDepartment of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China. zoujinghb@hotmail.com.ORCID http://orcid.org/0000-0002-0315-7092
Hongbin LiDepartment of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Minhui ZhuDepartment of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Guoping ZhangDepartment of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Yingna GaoDepartment of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Tianhao LuDepartment of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Antti ArnisaloDepartment of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Ilmari PyykköHearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.

Funding

National Natural Science Foundation of China 81771006
6 · The paper itself

Abstract

purposeTo evaluate the long-term efficacy of dual-target corticosteroid therapy (simultaneously targeting the endolymphatic sac [ES] and vestibule) in refractory Ménière's disease (MD) and assess associations between treatment outcomes, vestibular aqueduct (VA) patency, and endotypes. MATERIALS AND

methodsTwenty refractory MD patients with inadequate response to conventional therapies, including intratympanic dexamethasone, underwent gadolinium-enhanced MRI for endolymphatic hydrops (EH) evaluation. VA morphology and angular trajectory (ATVA) were assessed via CT. Methylprednisolone and dexamethasone were delivered to the intact ES surface, while dexamethasone was administered via the oval window (OW) for vestibule-targeted distribution. Follow-up duration: 30.1 ± 13.7 months (mean ± SD).

resultsYounger patients exhibited more severe cochlear (p < 0.01) and vestibular (p < 0.05) EH. Vestibular EH correlated with vertigo duration (p < 0.05), and disease stage was associated with EH severity (p < 0.05). 90% had narrow VA (grades I-II). ATVA αexit ranged 87.40°-158.69° (mean 116.16° ± 20.32°), with 12% (2/17) > 140°. EH severity correlated with ATVA αexit (p < 0.05) but not VA grade. Vertigo abolition: 95% at 3 days; 84.2% achieved ≥ level B control by endpoint. VA size and ATVA did not influence outcomes (p > 0.05).

conclusionsDual-target corticosteroid therapy provides robust and sustained vertigo control in refractory MD, independent of VA anatomy. Most patients had stenotic or undetectable VAs, yet neither VA patency nor ATVA affected efficacy, suggesting compensatory drug delivery mechanisms overcome anatomical limitations.

Indexed as

DexamethasoneGlucocorticoidsMeniere DiseaseMethylprednisoloneVestibular AqueductAdultAgedContrast MediaFemaleGadoliniumHumansInjection, IntratympanicMagnetic Resonance ImagingMaleMiddle AgedOval Window, EarContrast MediaDexamethasoneGadoliniumGlucocorticoidsMethylprednisoloneCorticosteroidsEndolymphatic hydropsMénière’s diseaseSurgical therapyTargeted drug delivery

Identifiers

PMID40615707

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.