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The traditional treatment of these disorders, corticosteroids and\/or cyclophosphamide (Cytoxan), has been associated with serious and occasionally life\u2010threatening complications. In this study we report our experience in treating 25 patients with immune\u2010mediated cochleovestibular disorders with methotrexate, a less toxic immunosuppressive agent that has been used extensively in patients with rheumatoid arthritis. Mean duration of treatment was 12.9 months, and adverse reactions were acceptable and reversible. Hearing improved in 69.6% of patients, and vestibular symptoms subsided or improved in 80% of patients. The results of this study suggest that methotrexate treatment is effective in a substantial number of patients with immune\u2010mediated cochleovestibular disorders and has acceptable adverse reactions. A prospective, randomized study is needed to compare the efficacy of methotrexate with that of other immunosuppressive agents.<\/jats:p>","DOI":"10.1016\/s0194-59989770316-4","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T13:27:21Z","timestamp":1664371641000},"page":"146-152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Methotrexate Management of Immune\u2010Mediated Cochleovestibular Disorders"],"prefix":"10.1002","volume":"116","author":[{"given":"Aristides","family":"Sismanis","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical College of Virginia\/Virginia Commonwealth University Richmond Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Wise","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\u2013Rheumatology Medical College of 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