Intratympanic Steroids for Sudden Sensorineural Hearing Loss

AbstractBackground:Sudden sensorineural hearing loss is a true audiological emergency, and its management is much discussed. Currently, no single therapy has been proven effective according to evidence criteria. Recently, intratympanic application of steroids has been increasingly used in refractory cases; however, it has only rarely been reported as first-line therapy.Materials and methods:Twenty consecutive patients with sudden sensorineural hearing loss treated between July 2008 and January 2010 were enrolled in this prospective, case–control study. Ten patients were treated with intratympanic steroids and 10 with systemic ‘shotgun’ therapy (including steroids, pentoxifylline, low molecular weight heparin and vitamin E). The two groups were homogeneous in all respects. Pure tone averages were assessed before and after treatment for both groups.Results:There were no statistically significant differences between the two groups.Conclusion:Intratympanic steroids seem to offer a valid alternative to systemic therapy, with few risks, in sudden sensorineural hearing loss patients, and we recommend their use as first-line therapy.

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Long-term follow up of sudden sensorineural hearing loss patients treated with intratympanic steroids: audiological and quality of life evaluation

The Journal of Laryngology & Otology ◽

10.1017/s0022215114001595 ◽

2014 ◽

Vol 128 (8) ◽

pp. 669-673 ◽

Cited By ~ 12

Author(s):

I Dallan ◽

S Fortunato ◽

A P Casani ◽

E Bernardini ◽

S Sellari-Franceschini ◽

...

Keyword(s):

Quality Of Life ◽

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Glasgow Benefit Inventory ◽

Intratympanic Steroids

AbstractObjective:To evaluate the long-term stability of intratympanic steroids and investigate the ‘real’ impact of sudden sensorineural hearing loss on patients.Method:A total of 14 patients treated with intratympanic steroids were evaluated by audiometric and vestibular examinations. The modified Glasgow Benefit Inventory was used to evaluate quality of life changes after intratympanic steroid treatment.Results:There was no significant difference between pure tone average post-intratympanic steroids and at follow up. The general Glasgow Benefit Inventory score was not significantly associated with the presence of tinnitus or dizziness, or with patient age. The change in pure tone average after intratympanic steroid treatment did not correlate with social or physical scores, but correlated strongly with the general Glasgow Benefit Inventory score (p = 0.0023). Intratympanic steroid administration led to a stable improvement in hearing. Quality of life assessment showed that patients can feel satisfaction regardless of the hearing outcome. Patients who regained a social hearing level expressed greater satisfaction than patients without serviceable hearing. Overall, quality of life improvement was not related to hearing improvement.Conclusion:Sudden sensorineural hearing loss is devastating. Considering the audiological effects alone ignores the ‘human’ perspective. Audiological success can correlate with poor quality of life outcome.

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Systemic steroids and intratympanic steroids perfusion as an initial therapy for idiopathic sudden sensorineural hearing loss, a comparative study

The Egyptian Journal of Otolaryngology ◽

10.4103/1012-5574.138472 ◽

2014 ◽

Vol 30 (3) ◽

pp. 215 ◽

Cited By ~ 1

Author(s):

Mohamed Mosleh ◽

Wael Wageeh ◽

Maha Abou-Elew ◽

Hesham Fathy ◽

MahmoudA El Hassan ◽

...

Keyword(s):

Hearing Loss ◽

Comparative Study ◽

Sensorineural Hearing Loss ◽

Initial Therapy ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Systemic Steroids ◽

Intratympanic Steroids

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Intratympanic Steroids for Treatment of Sudden Hearing Loss after Failure of Intravenous Therapy

Otolaryngology ◽

10.1016/j.otohns.2007.01.022 ◽

2007 ◽

Vol 137 (1) ◽

pp. 74-78 ◽

Cited By ~ 59

Author(s):

Guillermo Plaza ◽

Carlos Herráiz

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Standard Treatment ◽

Sudden Hearing Loss ◽

Sudden Onset ◽

Sudden Sensorineural Hearing Loss ◽

Steroid Treatment ◽

Sensorineural Hearing ◽

Intravenous Steroid ◽

Intratympanic Steroids

OBJECTIVE: We sought to describe our experience with intratympanic steroid treatment of sudden sensorineural hearing loss after failure of intravenous steroid treatment. STUDY DESIGN AND SETTING: We conducted a nonrandomized prospective clinical trial. Fifty patients presenting with sudden onset idiopathic hearing loss were treated intravenously over five days. After this period, patients with treatment failure (18 cases) were offered intratympanic steroid treatment. Nine patients refused, whereas the other nine patients received three weekly injections of methylprednisolone. Recovery of hearing was reported as improvement of more than 15 dB in pure tone average. RESULTS: Intratympanic steroid treatment improved hearing loss in five patients (55%). This is significant compared with those patients who refused intratympanic treatment, who showed no further improvement ( P < 0.05). No serious adverse effects were observed. CONCLUSION: Intratympanic steroids significantly improve the recovery outcome of sudden hearing loss that had not recovered after intravenous steroid treatment. SIGNIFICANCE: Intratympanic steroids are an effective and safe therapy in sudden sensorineural hearing loss cases that are refractory to standard treatment.

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High Dose of Intratympanic Steroids for Sudden Sensorineural Hearing Loss Salvage

Otology & Neurotology ◽

10.1097/mao.0000000000002386 ◽

2019 ◽

Vol 40 (9) ◽

pp. 1134-1138 ◽

Cited By ~ 2

Author(s):

Ahmed Taha ◽

Nathan Shlamkovitch ◽

Rani Abu-Eta ◽

Eyal Yeheskeli ◽

Limor Muallem-Kalmovich ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

High Dose ◽

Intratympanic Steroids

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Intratympanic steroids as a salvage therapy for severe to profound idiopathic sudden sensorineural hearing loss

Acta Oto-Laryngologica ◽

10.1080/00016489.2018.1497805 ◽

2018 ◽

Vol 138 (11) ◽

pp. 966-971 ◽

Cited By ~ 3

Author(s):

Edoardo Covelli ◽

Khaled Altabaa ◽

Benjamin Verillaud ◽

Domitille Camous ◽

Charlotte Hautefort ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Salvage Therapy ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Intratympanic Steroids

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Efficacy of Intratympanic Glucocorticoid Steroid Administration Therapy as an Initial Treatment for Idiopathic Sudden Sensorineural Hearing Loss During the COVID-19 Pandemic

Ear Nose & Throat Journal ◽

10.1177/01455613211032534 ◽

2021 ◽

pp. 014556132110325

Author(s):

Takeshi Tsuda ◽

Yukiko Hanada ◽

Kento Wada ◽

Erina Fujiwara ◽

Kazuya Takeda ◽

...

Keyword(s):

Hearing Loss ◽

Side Effects ◽

Sensorineural Hearing Loss ◽

Steroid Therapy ◽

Initial Treatment ◽

Additional Treatment ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Intravenous Steroid ◽

Intratympanic Steroids

Objective: Systemic administration of glucocorticoid steroids is the most common initial treatment for idiopathic sudden sensorineural hearing loss (ISSNHL); however, due to the prevalence of coronavirus disease, the indications for this treatment must be carefully determined. The aim of this study was to investigate the efficacy of intratympanic steroid therapy as an initial treatment for idiopathic SSNHL. Methods: Sixty-eight patients with idiopathic ISSNHL who were treated with intravenous or intratympanic steroids were included in this study. Patients were retrospectively evaluated regarding preoperative grade, type of additional treatment, outcome of treatment, and side effects of each treatment. Results: In 46 cases, patients received intravenous steroid therapy as the initial treatment, while 22 patients received intratympanic steroid therapy; 10 patients underwent salvage treatment due to inadequate improvement of symptoms. Regarding additional treatment, intravenous steroid monotherapy was used in 37 patients. The outcomes were similar after both treatments; 16 (43%) and 11 (52%) patients treated exclusively with intravenous and intratympanic steroids, respectively, were completely cured. There were no significant differences in the effects between the 2 treatments, indicating that they were almost equally effective. The side effects observed in patients treated with intravenous steroid therapy were increased blood pressure, acute gastric mucosal disorder, and insomnia. None of these side effects were observed in any of the patients treated with intratympanic steroids; however, 1 case of perforation of the tympanic membrane occurred due to the procedure. Conclusion: There were no significant differences in posttreatment outcomes between patients treated with either intratympanic or intravenous steroids. The therapeutic effects were comparable, and no severe side effects were observed; therefore, intratympanic steroid therapy may be considered useful as an initial treatment for ISSNHL in the context of widespread coronavirus disease.

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