Effectiveness of Intratympanic Dexamethasone Injection in Sudden‐Deafness Patients as Salvage Treatment

Ho, Guan‐Min; Lin, Hung-Ching; Shu, Min-Tsan; Cheng-Chien, Yang; Tsai, Hsun-Tien

doi:10.1097/00005537-200407000-00010

Cited by 176 publications

(67 citation statements)

References 16 publications

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“…In reviewing the SSNHL studies in tables 2 and 3, 13 studies had controls [4,23,24,25,26,27,28,29,30,31,32,33,34]; however, the controls were all some form of systemic steroids. None of the studies had placebo as their control.…”

Section: Resultsmentioning

confidence: 99%

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Intratympanic Steroids for Inner Ear Disorders: A Review

Parnes

2009

Audiol Neurotol

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Background/Aim: The use of intratympanic steroids (ITS) has proliferated over the past 10–15 years to include treatments for inner ear disorders, like Ménière’s Disease (MD) and sudden sensorineural hearing loss (SSNHL). The aim of this study was to review the clinical trials of ITS for inner ear disorders. Methods: PubMed and Ovid Medline databases were searched from 1966 to present for clinical trials on ITS in the treatment of MD and SSNHL. Studies were evaluated based on comparability and internal and external validity. Results: Thirty-eight studies were identified in total, 13 studies on MD and 25 studies on SSNHL. Most studies lacked placebo controls. Only 3 studies were double-blinded randomized prospective trials. Overall, there were heterogeneous steroid doses, treatment protocols, previous treatments, and definitions of disease and improvement. Conclusion: There are no good studies on ITS that meet the criteria of comparability, internal validity, and external validity. It is difficult to compare studies due to the heterogeneous nature of the data. More rigorously designed studies are required to determine the efficacy of this treatment, the optimal steroid to use, and the best treatment regimen.

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Section: Resultsmentioning

confidence: 99%

“…The 4 level one evidence studies were all prospective randomized studies [23,24,25,26]. Three of these studies were positive [23,25,26], while the fourth was negative [24].…”

Section: Resultsmentioning

confidence: 99%

Intratympanic Steroids for Inner Ear Disorders: A Review

Parnes

2009

Audiol Neurotol

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“…Gentamicin is toxic to the sensory cells of the balance system and thereby suppresses the vertigo in these patients by partially ablating their vestibular system. There are also an increasing number of clinical reports related to the local application of glucocorticoids for acute hearing loss (9,10,11,12,13,14,15,16), glucocorticoids for Menière's disease (17,18,19,20) or for tinnitus (21,22,23,24,25). Other substances that have been tested in humans include local anaesthetics, neurotransmitters and neurotransmitter antagonists (26,27).…”

Section: Introductionmentioning

confidence: 99%

Local inner-ear drug delivery and pharmacokinetics

Salt

Plontke

2005

Drug Discovery Today

163

123

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SummaryA number of drugs are in widespread clinical use for the treatment of inner ear disorders by applying them directly to the inner ear. Many new substances and drug delivery systems specific to the inner ear are under development, and in some cases are undergoing evaluations in animal experiments and in clinical studies. The pharmacokinetics of drugs in the inner ear, however, is not well defined and the field is plagued by technical problems in obtaining pure samples of the inner ear fluids for analysis. Nevertheless, a basic understanding of the mechanisms of drug dispersal in the inner ear has emerged that facilitates the design and interpretation of future pharmacokinetic studies.

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“…Audiograms were performed after each of 3 injections. 5 The greatest response to treatment was 7 days after the first injection with a steadily decreasing steroid effect there-after. There were significant differences between the PTA after the first and third injection, corresponding to 7 and 21 days after treatment began.…”

Section: Resultsmentioning

confidence: 97%

“…Intratympanic steroids (ITSs) may treat ISSNHL more effectively than oral steroids. [5][6][7][8][9][10][11][12] Data to support this hypothesis are limited almost exclusively to case series, which differ in the type of steroid used, the steroid dose, the dose frequency, the method of injection, the existence of previous treatment with oral steroids, and the outcome measurements. Most cases of sudden hearing loss are idiopathic not because they do not have a cause but because we are unable to identify it.…”

Section: Introductionmentioning

confidence: 99%

Effect of intratympanic dexamethasone injection in sudden idiopathic sensorineural hearing loss

Swamy

Ganiger

2016

Int J Otorhinolaryngol Head Neck Surg

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Background: The aim of this study is to assess the effect of intratympanic dexamethasone injection (ITDI) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).Methods: A prospective study was conducted on 40 patients refractory to intravenous steroid therapy between May 2012 to March 2014. Intratympanic dexamethasone injection was given every week for 3 consecutive weeks. Hearing was assessed by performing pure tone audiogram before every ITDI and also 1 week after the completion of treatment.Results: Hearing improvement was seen in 27 out of the 40 cases (68%).Conclusions: Intratympanic dexamethasone significantly improves the prognosis of ISSNHL and is a safe, inexpensive and effective treatment in ISSNHL.

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Effectiveness of Intratympanic Dexamethasone Injection in Sudden‐Deafness Patients as Salvage Treatment

Abstract: IT-DEX injection effectively improves hearing in patients with severe or profound SSNHL after treatment failure with standard therapy and is not associated with major side effects. It is therefore a reasonable alternative as salvage treatment.

Cited by 176 publications

References 16 publications

Intratympanic Steroids for Inner Ear Disorders: A Review

Intratympanic Steroids for Inner Ear Disorders: A Review

Local inner-ear drug delivery and pharmacokinetics

Effect of intratympanic dexamethasone injection in sudden idiopathic sensorineural hearing loss

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