In some instances, your specialist may recommend that you undergo an injection of gentamicin into the middle ear instead of a steroid. Gentamicin is an antibiotic which is known to have mildly toxic effects on both the balance and hearing parts of the ear, although its toxic effects on the vestibular system are very much more potent than on the hearing. Despite this, there is an increased chance of a hearing loss occurring with intratympanic gentamicin injections. For this reason, they are usually reserved for patients with a pre-existing severe hearing loss at the time the vertigo is diagnosed.
An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location.
How often cortisone injections are given varies based on the reason for the injection. This is determined on a case-by-case basis by the health care practitioner. If a single cortisone injection is curative, then further injections are unnecessary. Sometimes, a series of injections might be necessary; for example, cortisone injections for a trigger finger may be given every three weeks, to a maximum of three times in one affected finger. In other instances, such as knee osteoarthritis, a second cortisone injection may be given approximately three months after the first injection, but the injections are not generally continued on a regular basis.