Abstract：
OBJECTIVE: Intratympanic (IT) drug delivery receives attention due to its effectivity in treatment for Menière\'s disease (MD). Due to the release of the consensuses and new evidence on IT drug delivery for MD have been published, the review with a view to supplementing the details of IT treatment of MD is indispensable.
METHODS: The literatures on IT injection for MD treatment over the last two decades are retrieved, International consensus (ICON) on treatment of Menière\'s disease (2018), Clinical Practice Guideline (2020) and European Position statement on Diagnosis and Treatment of Meniere\'s Disease (2018) are taken into account for reference, and follow advice from experts from Europe, USA and China.
RESULTS: Experts agree on the following: (1) The effectiveness of IT methylprednisolone (ITM) on vertigo control seems to be somewhat better than that of IT dexamethasone (ITD), and ITM can restore hearing in some cases. (2) Due to the ototoxicity of aminoglycosides, the application of intratympanic gentamicin (ITG) in MD patients with good hearing is conservative. However, some studies suggest that ITG with low doses has no significant effect on hearing, which needs to be further proved by clinical studies with high levels of evidence. (3) Currently, generally accepted treatment endpoint of ITG is no vertigo attack in a 12-month period or a vestibular loss in objective tests in the affected ear.
CONCLUSIONS: More studies with high level of evidence are needed to evaluate the drug type, efficacy, and therapeutic endpoint of IT therapy for MD.
METHODS: The literatures on IT injection for MD treatment over the last two decades are retrieved, International consensus (ICON) on treatment of Menière\'s disease (2018), Clinical Practice Guideline (2020) and European Position statement on Diagnosis and Treatment of Meniere\'s Disease (2018) are taken into account for reference, and follow advice from experts from Europe, USA and China.
RESULTS: Experts agree on the following: (1) The effectiveness of IT methylprednisolone (ITM) on vertigo control seems to be somewhat better than that of IT dexamethasone (ITD), and ITM can restore hearing in some cases. (2) Due to the ototoxicity of aminoglycosides, the application of intratympanic gentamicin (ITG) in MD patients with good hearing is conservative. However, some studies suggest that ITG with low doses has no significant effect on hearing, which needs to be further proved by clinical studies with high levels of evidence. (3) Currently, generally accepted treatment endpoint of ITG is no vertigo attack in a 12-month period or a vestibular loss in objective tests in the affected ear.
CONCLUSIONS: More studies with high level of evidence are needed to evaluate the drug type, efficacy, and therapeutic endpoint of IT therapy for MD.
摘要：
目的：鼓室内（IT）药物递送因其在治疗梅尼埃病（MD）方面的有效性而受到关注。由于已经发布了关于MD的IT药物递送的共识和新证据，为了补充MD的IT治疗细节而进行的审查是必不可少的。
方法：检索了过去二十年来用于MD治疗的IT注射文献，关于梅尼埃病治疗的国际共识(ICON)(2018年)，临床实践指南(2020年)和欧洲关于梅尼埃病诊断和治疗的立场声明(2018年)被纳入参考。听从欧洲专家的建议，美国和中国。
结果：专家同意以下几点：（1）IT甲基强的松龙（ITM）对眩晕控制的有效性似乎比IT地塞米松（ITD）要好一些，在某些情况下，ITM可以恢复听力。（2）由于氨基糖苷类的耳毒性，鼓室内庆大霉素（ITG）在听力良好的MD患者中的应用是保守的。然而,一些研究表明，低剂量的ITG对听力没有显著影响，这需要有高水平证据的临床研究进一步证明。（3）目前，ITG的普遍接受的治疗终点是12个月内无眩晕发作,或在受影响的耳朵的客观测试中无前庭丢失.
结论：需要更多具有高水平证据的研究来评估药物类型，功效,和MD的IT治疗终点。
方法：检索了过去二十年来用于MD治疗的IT注射文献，关于梅尼埃病治疗的国际共识(ICON)(2018年)，临床实践指南(2020年)和欧洲关于梅尼埃病诊断和治疗的立场声明(2018年)被纳入参考。听从欧洲专家的建议，美国和中国。
结果：专家同意以下几点：（1）IT甲基强的松龙（ITM）对眩晕控制的有效性似乎比IT地塞米松（ITD）要好一些，在某些情况下，ITM可以恢复听力。（2）由于氨基糖苷类的耳毒性，鼓室内庆大霉素（ITG）在听力良好的MD患者中的应用是保守的。然而,一些研究表明，低剂量的ITG对听力没有显著影响，这需要有高水平证据的临床研究进一步证明。（3）目前，ITG的普遍接受的治疗终点是12个月内无眩晕发作,或在受影响的耳朵的客观测试中无前庭丢失.
结论：需要更多具有高水平证据的研究来评估药物类型，功效,和MD的IT治疗终点。
