If there is no hearing improvement or only partial improvement, then a series of intratympanic dexamethasone (10 mg/mL) injections are offered as salvage therapy
However, these are indicated only for acute exposure, and acetazolamide presents adverse effects such as paresthesia, dysgeusia, hyperglycemia, and rebound symptoms, limiting its long-term use ( Consequently, studies have evaluated antioxidant compounds such as vitamins C and E, -lipoic acid, and more recently standardized Ginkgo biloba extract, which has been attributed to potential antioxidant effects
Any combination protocol is strictly investigational and outside the evidence base summarised in this article
Nature 432 , 622625 (2004)
Antimicrobial properties of lactoferrin