Hearing Outcomes and Prognostic Factors in Idiopathic Sudden Sensorineural Hearing Loss Patients with Combined Intratympanic and Systemic Steroid Therapy

Background and Objectives Steroid treatment is used as a main treatment modality for sudden sensorineural hearing loss (SSNHL). Intratympanic injection of steroid (ITS) has been used and its therapeutic efficacy reported as being comparable to the systemic steroid administration (SS). This study compares the hearing outcomes of using ITS and SS simultaneously and SS alone.Subjects and Method Retrospective chart review was performed for 146 patients with SSNHL. The patients were divided into 2 groups according to the method of treatment (SS and ITS simultaneously vs. SS alone). The inclusion criteria were starting treatment within 7 days after onset, and follow up pure tone audiometry at least 4 weeks after treatment. Hearing gain for pure tone threshold of each frequency and average of 4 frequencies (500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz) were compared between both groups.Results The improvement in PTA at 1-month follow-up was 27.3±20.0 dB HL in the simultaneous group and 19.1±19.5 dB HL in the SS alone group; this was not statistically significant. Complete or partial recovery at 1-month follow-up was observed in 65.3% of the simultaneous group and 69.6% of the SS alone group; this was also not significant.Conclusion There was no significant difference in hearing outcomes between the simultaneous and SS alone group. The simultaneous therapy does not appear to be superior to the SS alone therapy. Further studies using more population and longer follow-up periods are necessary.

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Intratympanic Steroid Perfusion for Refractory Sudden Sensorineural Hearing Loss

Otolaryngology ◽

10.1016/j.otohns.2004.09.138 ◽

2005 ◽

Vol 132 (4) ◽

pp. 527-531 ◽

Cited By ~ 73

Author(s):

Brian D. Herr ◽

Sam J. Marzo

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Steroid Therapy ◽

Round Window ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Catheter Placement ◽

Oral Steroid ◽

Systemic Steroid ◽

Steroid Administration

OBJECTIVE: Patients with sudden sensorineural hearing loss (SSHL) can benefit from systemic steroid therapy. Unfortunately, some patients are not candidates for steroid therapy due to concern over possible complications. Furthermore, not all patients will benefit from steroid administration. This study evaluates the potential benefits and safety of treating patients with SSHL refractory to oral steroids with intratympanic steroid therapy. METHODS: A retrospective case review was performed on all patients who presented with sudden sensorineural hearing loss refractory to oral steroid therapy during the past year. Seventeen patients were identified. All patients underwent intratympanic steroid administration, via MicroWick placement and/or round window catheter placement. RESULTS: Nine patients with sudden sensorineural hearing loss showed an improvement with intratympanic steroid therapy, consisting of MicroWick placement with dexamethasone drop (Decadron) administration for 1–2 weeks and/or round window catheter placement with steroid perfusion. Only one of the patients presenting with hearing loss present for greater than 8 weeks benefited from intratympanic therapy. Complications were few and included tympanic membrane perforation, chronic otitis media, dysequilibrium, and dysguesia. CONCLUSIONS: Intratympanic steroid therapy can be beneficial in treating patients with sudden sensorineural hearing loss refractory to oral steroid use. EBM rating: C.

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