Clinical efficacy of initial intratympanic steroid treatment on sudden sensorineural hearing loss with diabetes

2009 ◽  
Vol 141 (5) ◽  
pp. 572-578 ◽  
Author(s):  
Chi-Sung Han ◽  
Jong-Ryul Park ◽  
Sung-Hyun Boo ◽  
Joon-Man Jo ◽  
Kyung-Won Park ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Initial Treatment ◽  
Sudden Sensorineural Hearing Loss ◽  
Steroid Treatment ◽  
Sensorineural Hearing ◽  
Systemic Steroid ◽  
Significant Difference ◽  
Before And After ◽  
Patients With Diabetes

Objective: The purpose of this study is to compare the efficacy of intratympanic steroid injection (ITSI) with that of systemic steroids as an initial treatment of sudden sensorineural hearing loss (SNHL) with diabetes. Study Design: Prospective, nonrandomized multicenter clinical trial. Setting: Multicenter study in Busan and Masan, South Korea. Subjects and Methods: A total of 114 sudden SNHL patients who were diagnosed with diabetes were divided into peroral (PO) group (n = 48), intravenous (IV) group (n = 32), and intratympanic (IT) group (n = 34). In the PO group, prednisolone was used orally for 10 days, per schedule. In the IV group, prednisolone was administered intravenously for seven days, followed by oral administration of tapered doses for another several days. In the IT group, dexamethasone was injected into the tympanic cavity four times within a two-week period. Hearing outcome was assessed before and after the treatment. Results: All groups showed significant improvement with criteria of 15 dB ( P < 0.05). However, there was no significant difference in hearing gain and recovery rate among groups ( P > 0.05). Systemic steroid treatment was stopped for two patients in the IV group and for one in the PO group due to uncontrolled hyperglycemia. However, in the IT group, there were no patients who failed to control their blood sugar level. Conclusion: ITSI is as effective as systemic steroid treatment for sudden SNHL patients with diabetes and it can avoid undesirable side effects. Therefore, we consider ITSI to be a more reasonable alternative as an initial treatment for sudden SNHL patients with diabetes.

Idiopathic Sudden Sensorineural Hearing Loss in Children: A Systematic Review and Meta-analysis

2020 ◽  
pp. 019459982097657
Author(s):  
Leonardo Franz ◽  
Chiara Gallo ◽  
Gino Marioni ◽  
Cosimo de Filippis ◽  
Andrea Lovato
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Case Reports ◽  
Meta Analysis ◽  
Treatment Options ◽  
Case Series ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Systemic Steroid ◽  
Significant Difference

Objective Idiopathic sudden sensorineural hearing loss (ISSNHL) is uncommon in children, and its treatment and outcome are debated. We aimed to critically review evidence in the literature about treatment options and functional outcomes of pediatric ISSNHL. Additionally, we performed a meta-analysis of the results of combined systemic-intratympanic steroid therapy versus solely systemic treatment. Data Sources A search was run in the PubMed, Scopus, and Google Scholar databases. Review Methods Included articles were original ISSNHL case series, written in English, with a population age ranging from 2 to 19 years. Other study types (single case reports, editorials, and reviews) and case series with known etiology of sudden hearing loss were excluded. Descriptive data of patients, treatments, outcomes, and possible prognostic factors were extracted and recorded for every included study. Results Twelve articles (7 cohort and 5 case-control studies) met all the selection criteria. Based on only the studies that provided sufficient data about clinical outcome, the pooled overall recovery rate was 67.91% (95% CI, 58.34%-77.48%). No studies showed a significant difference between systemic steroid and combined systemic-intratympanic steroid. The pooled odds ratio for combined systemic-intratympanic steroid versus systemic steroid alone was 0.90 (95% CI, 0.36-2.27) based on a random effects model, ruling out any significant difference between these treatment options. Conclusions The results of our meta-analysis did not support combination therapy more than systemic steroid alone. Further prospective clinical trials are necessary to establish evidence-based therapies.

scholarly journals Comparison of Steroid Treatment with and without Hyperbaric Oxygen Therapy for Idiopathic Sudden Sensorineural Hearing Loss

2020 ◽  
Vol 24 (3) ◽  
pp. 127-132 ◽  
Author(s):  
Abitter Yücel ◽  
Yaşar Özbuğday
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hyperbaric Oxygen ◽  
Sudden Sensorineural Hearing Loss ◽  
Steroid Treatment ◽  
Sensorineural Hearing ◽  
Profound Hearing Loss ◽  
Hearing Gain ◽  
Admission Time ◽  
Significant Difference

Background and Objectives: In this study, we compared the outcomes of patients with idiopathic sudden sensorineural hearing loss who underwent steroid treatment with or without hyperbaric oxygen (HBO) therapy and were followed-up in our clinic.Subjects and Methods: Patients were divided into two groups according to their treatment regimen. Steroid group received intravenous 1 mg/kg methylprednisolone which was due to be completed in 2-3 weeks with decreasing doses, and five doses of 0.5 mL intratympanic dexamethasone. Steroid+HBO group received the same steroid treatment with the addition of HBO therapy. The audiologic results of both treatment groups were compared after considering the patients’ risk factors.Results: There was no significant difference between the steroid and Steroid+HBO groups in terms of hearing gain and degree of recovery, both at all degrees of hearing loss, and in severe and profound hearing loss. Hearing gain was similar when evaluated by audiogram type and admission time in both treatment groups.Conclusions: We found that the addition of HBO therapy to systemic plus intratympanic steroid treatment did not affect hearing gain at all degrees of hearing loss in this study. Furthermore, audiogram type and admission time did not affect hearing gain between the two groups.

Better late than never: initial experience of intra-arterial pulsed-urokinase-injection as a salvage therapy for refractory sudden sensorineural hearing loss

2021 ◽  
pp. 159101992110568
Author(s):  
Yang Cui ◽  
Wenzhao Liang ◽  
Mengxue Li ◽  
Zhongyu Zhao ◽  
Xinzhao Jiang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Salvage Therapy ◽  
Conventional Therapy ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Control Group ◽  
Before And After ◽  
Patient Database ◽  
Vascular Origin

Background and Purpose Cochlear vascular micro-thrombosis has been hypothesized as one of the pathogenic mechanisms for sudden sensorineural hearing loss (SSNHL) refractory to regular management. This study aimed to evaluate the feasibility and safety of intra-arterial pulsed-injection urokinase (IAPU) as a salvage therapy for SSNHL after the failure of conventional therapy. Methods We retrospectively reviewed our patient database to identify refractory SSNHL patients between November 2017 and July 2020. Study outcomes before and after the IAPU therapy were compared between IAPU and conventional therapy groups. Results Sixty-seven moderate-profound SSNHL patients (29 in IAUP group, 38 in control group) were included in this study. Compared to the control group, patients in the IAPU group showed more significant improvement in pure tone average (PTA) (34.2 ± 23.5 vs. 10.7 ± 13.1, p < 0.001) and degree of hearing recovery (total: 20.7% vs. 5.3%, partial: 24.1% vs. 10.5%, mild: 27.6% vs. 13.2% and non: 27.6% vs. 71.1%) 2 weeks after admission. In the IAPU group, a significant improvement of PTA (86.6 ± 11.5 vs. 54.6 ± 20.1 dB, p < 0.005) was observed on the first day after IAPU treatment. Conclusion In carefully selected SSNHL cases with a highly suspected vascular origin, IAPU is a safe and effective therapy when conventional treatments have failed. Despite the encouraging findings of our work, large studies are needed to better investigate the strengths and limitations of this salvage therapy.

scholarly journals Metformin decreases the risk of sudden sensorineural hearing loss in patients with diabetes mellitus: A 14-year follow-up study

2019 ◽  
Vol 16 (4) ◽  
pp. 324-327 ◽  
Author(s):  
Hsin-Chien Chen ◽  
Chi-Hsiang Chung ◽  
Chieh-Hua Lu ◽  
Wu-Chien Chien
Keyword(s):  
Diabetes Mellitus ◽  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Cox Regression ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Lower Percentage ◽  
Research Database ◽  
Patients With Diabetes

Background: The risk of sudden sensorineural hearing loss associated with metformin use in patients with diabetes mellitus has not been fully examined. Study design: It is a retrospective matched-cohort study. Subjects and methods: We examined the medical records of patients with diabetes mellitus over 18 years old in Taiwan’s National Health Insurance Research Database for the period between 1 January 2000 and 31 December 2013, to establish matched cohorts (14,109 with and 42,327 without metformin use) at a ratio of 1:3 by sex, age and index year. Results: We used a Cox regression hazard model to identify risk factors of sudden sensorineural hearing loss during 14 years of follow-up, and the results indicate that a significantly lower percentage of diabetes mellitus patients with metformin use ( p = 0.033) developed sudden sensorineural hearing loss compared with those without metformin use (0.21%, 29/14,109 vs 0.32%, 136/42,327). After adjustment for age and other variables [adjusted hazard ratio: 0.630 (95% confidence interval: 0.422–0.941, p = 0.024)], this study also demonstrated that metformin use appeared to reduce the risk of developing sudden sensorineural hearing loss. Conclusion: This study demonstrated an association between metformin use and lower incidence of sudden sensorineural hearing loss among patients with diabetes mellitus.

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