Clinical Analysis of Intratympanic Injection of Dexamethasone for Treating Sudden Deafness

Abstract

Introduction A variety of causes may induce sudden deafness. However, it remains challenging to determine the exact cause in a clinic. There is no standard treatment for this disease due to its unclear etiology. Objective The present study aims to investigate the clinical efficacy of the intratympanic injection of dexamethasone for treating sudden deafness. Methods A total of 154 patients with sudden deafness were retrospectively analyzed. The evaluation of sudden deafness was based on the AAO-HNS efficacy evaluative criteria. All patients were initially treated within seven days by an intravenous drip of methylprednisolone, vasodilator, and neurotrophic agents. These patients were divided into two groups: the treatment group (91 patients) and the control group (63 patients). Patients in the treatment group were given an intratympanic injection of dexamethasone, while patients in the control group were given conventional vasodilators and neurotrophic treatment. Results The effective rate in the treatment group was 47.25% (43/91 patients), and this was significantly higher than in the control group (14.29%, 9/63 patients). The adverse reactions in the treatment group included transient pain (7.69%, 7/91), but there was no vertigo in either group. There was one case of tympanic membrane perforation. Conclusion The intratympanic injection of dexamethasone is a better choice for refractory sudden deafness due to its high efficacy and fewer adverse reactions.

Dexamethasone for Inner Ear Therapy: Biocompatibility and Bio-Efficacy of Different Dexamethasone Formulations In Vitro

“…To date, the exact mechanisms of sensorineural hearing loss (HL) are still not completely understood [ 3 ] but in preclinical and clinical otology fields, in vitro and in vivo studies and clinical trials are often conducted to seek pharmacotherapies of inner ear disorders [ 4 , 5 , 6 ]. Among these, inflammation-suppressing substances, such as glucocorticoids, and especially dexamethasone, have been widely tested as a potential therapy to treat inner ear pathologies including sudden sensorineural hearing loss (SSNHL) [ 7 , 8 , 9 , 10 ], Menière’s disease [ 11 , 12 , 13 , 14 ], and acute tinnitus [ 15 ]. Additionally, dexamethasone is intensively investigated for its benefit in cochlear implant (CI) patients [ 16 ].…”

The psychological intervention and clinical efficacy of Rosenthal effect and acupuncture bleeding on middle-aged and young patients with sudden hearing loss

“…If necessary, mecobalamin nutrition is supplemented to protect neural function. [ 14 ] Li et al [ 15 ] found that the treatment effectiveness of injecting corticosteroid drug dexamethasone into the tympanic cavity was better than that of the CG, and the efficacy of injecting dexamethasone into the tympanic membrane was better. Zhang et al [ 16 ] explored the value of coagulation markers in prognostic analysis of patients with SHL.…”

Pericytes of Stria Vascularis Are Targets of Cisplatin-Induced Ototoxicity: New Insights into the Molecular Mechanisms Involved in Blood-Labyrinth Barrier Breakdown

“…Although Dex is widely used for the treatment of diseases characterized by hearing loss, including sudden sensorineural hearing loss (SSNHL) [39] and Meniere's disease [64], there are in vivo studies showing that Dex had no effect [65] or that there was remarkable heterogeneity in treatment response across patients with SSNHL [66], and some even reported a toxic effect [38,66]. Moreover, to date, a significant knowledge gap exists relating to the localization of the action of corticosteroids in the inner ear and the cell types involved in their response [66].…”

“…Dexamethasone (Dex) is a steroid drug with a strong anti-inflammatory effect on cochlear tissues, capable of significantly reducing hearing loss when applied locally or systemically [38]. Dex has been shown to preserve hearing in guinea pig models of cochlear implantation [39], and at present, intra-tympanic injections of Dex are very effective in treating sudden deafness caused by circulatory disorders [39]. However, some studies highlight the negative side effects of Dex on inner ear tissues, including increased hearing loss [40].…”