Does age influence the success of intra-tympanic steroid treatment in idiopathic sudden deafness?

Attanasio, Giuseppe; Covelli, Edoardo; Cagnoni, Laura; Masci, Eleonora; Rosati, D; Porto, Edoardo Di; Barbara, Maurizio; Monini, Simonetta; Filipo, Roberto

doi:10.3109/00016489.2015.1060628

Cited by 9 publications

(3 citation statements)

References 15 publications

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“…Attanasio et al also reported that each additional day of ITSI treatment delay following the onset of hearing loss reduces the possibility of recovery by an average of 2% to 3%. 5,18 From another perspective, our study also revealed that ITSIs can still be beneficial even if they are delayed by more than 4 weeks after symptom onset, as evidenced by the 17.8% hearing improvement rate achieved by patients who underwent ITSI treatment more than 4 weeks after symptom onset. The results for delayed treatment group were comparable with previous studies: Haynes et al 19 reported 15.79% of cases improved hearing after the delayed salvage ITSIs (time to injection >1 month), using the criteria of 20-dB gain in PTA.…”

Section: Discussionsupporting

confidence: 53%

Clinical efficacy of intratympanic steroid injection for treating idiopathic sudden sensorineural hearing loss

Kuo,

Wu,

et al. 2024

Journal of the Chinese Medical Association

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Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is an emergency that causes permanent hearing loss if timely treatment is not provided. However, the evidence supporting the effect of intratympanic steroid injection (ITSI) starting time on hearing outcome is limited. Methods: We retrospectively enrolled 582 patients with ISSNHL who were treated with ITSIs and reviewed their clinical and audiological variables. The relationship between ITSI starting time and hearing recovery was analyzed. Results: The mean starting time of ITSI was 13.17 ± 16.53 days. The overall hearing recovery rate was 55.15% (recovery = mean hearing level gain of ≥10 dB). The recovery rates were 79.2%, 67.4%, 50%, 36.6%, and 17.8% for the ITSI starting times of 1–3 days, 4–7 days, 8–14 days, 15–28 days, and ≥29 days, respectively. A multivariate analysis revealed that ITST starting time (odds ratio [OR] = 0.94, 95% confidence interval [CI] = 0.92–0.96, p < 0.001) and salvage therapy (OR = 0.55, 95% CI = 0.35–0.86, p = 0.009) were independent poor prognostic factors for patients with ISSNHL. Conclusion: Earlier ITSI treatment is associated with a higher hearing recovery rate. Comorbidities and post-ITSI complication were nonsignificant independent risk factors.

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Section: Discussionsupporting

confidence: 53%

Clinical efficacy of intratympanic steroid injection for treating idiopathic sudden sensorineural hearing loss

Kuo,

Wu,

et al. 2024

Journal of the Chinese Medical Association

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“…8 In earlier literature, older age in treated ISSNHL patients tends to be associated with a worse prognosis [12][13][14][15] or no change in hearing improvement. [16][17][18] One prospective, longitudinal cohort study of 127 ISSNHL patients found no significant difference in PTA recovery rates in the various age groups studied (30, 31-50, 51-70, 71 years old), but did note a trend in poorer results in the more extreme age groups (30, 71 years old) 19 Attanasio et al 20 found increased age was associated with worse hearing outcomes in their study of 496 patients; on subgroup analysis divided by age >65 years old, patients in the older subgroup had a statistically significant higher PTA both pre-and posttreatment.…”

Section: Discussionmentioning

confidence: 96%

Oral and intratympanic steroid therapy for idiopathic sudden sensorineural hearing loss

Hara

Zhang

Gandhi

et al. 2018

Laryngoscope Investig Oto

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ObjectiveTo investigate the role of intratympanic (IT) therapy in the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL).MethodsThis study was a retrospective review. Patients were treated for ISSNHL from January 1, 2011 to April 12, 2015 with the following: pre/posttreatment audios, treatment initiated ≤90 days and idiopathic etiology. Fifty‐three ISSNHL patients were analyzed in the following subgroups: oral steroids (n = 8), combination oral+IT (n = 39), and IT (n = 6). Main outcomes measured were pre/posttreatment pure tone average (PTA) scores.ResultsThe PTA changes for all treatment groups improved by 8.0 ± 19.5 dB (P = .004); for 31 patients treated ≤2 weeks after onset, PTA improved by 13.8 ± 16.6 dB (P < .001). Multivariable generalized linear model for repeated measures was conducted to investigate the association between PTA changes for treatment groups adjusted for age, gender, time‐to‐treatment, and vertigo. Earlier time‐to‐treatment and older age were statistically correlated towards improved outcomes. As time‐to‐treatment increased by each day, change in PTA decreased by 0.324 (95% CI [0.12, 0.52], P = .002). As age increased by each year, PTA changes increased by 0.802 (95% CI [0.36, 1.24], P < .001). For the oral+IT group, PTA changes for concurrent oral+IT (n = 20, 7.10 dB) and delayed/salvage oral+IT (n = 19, 5.43 dB) were not statistically different (P = .79); earlier time‐to‐treatment (P = .001), and older age (P = .006) remained statistically correlated towards improved outcomes.ConclusionResults suggest outcomes can be improved with early identification and oral steroid therapy by primary care providers. Poorer prognosis for younger patients potentially suggests a need for more aggressive diagnostic and therapeutic management for this subgroup.Level of Evidence3b.

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“…However, there is no standard treatment for this disease due to the unclear etiology. 4 Thus, the clinical use of antiviral drugs, steroids, vasodilators, neurotrophic agents, and other drugs is an important choice for patients with sudden deafness.…”

Section: Introductionmentioning

confidence: 99%

Clinical Analysis of Intratympanic Injection of Dexamethasone for Treating Sudden Deafness

Li¹,

Chen²,

Xu³

et al. 2021

IJGM

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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.

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Does age influence the success of intra-tympanic steroid treatment in idiopathic sudden deafness?

Cited by 9 publications

References 15 publications

Clinical efficacy of intratympanic steroid injection for treating idiopathic sudden sensorineural hearing loss

Clinical efficacy of intratympanic steroid injection for treating idiopathic sudden sensorineural hearing loss

Oral and intratympanic steroid therapy for idiopathic sudden sensorineural hearing loss

Clinical Analysis of Intratympanic Injection of Dexamethasone for Treating Sudden Deafness

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