Intratympanic dexamethasone as initial therapy for idiopathic sudden sensorineural hearing loss: Clinical evaluation and laboratory investigation

Fu, Yaoyao; Zhao, Hui; Zhang, Tianyu; Chi, Fang‐Lu

doi:10.1016/j.anl.2010.07.008

Cited by 36 publications

(26 citation statements)

References 19 publications

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“…It has been reported that the combination of systemic steroids and ITS provides better hearing recovery than systemic steroid therapy alone in the primary treatment of SSNHL (25,26). However, some reports have not found a significant difference in the rate of hearing recovery between ITS plus systemic steroids and systemic steroids alone (27,28). The combination of steroids and HBO for the primary treatment of SSNHL has also shown promising results in previous reports (29Y31).…”

Section: Discussionmentioning

confidence: 98%

Comparison of Intratympanic Steroid Injection, Hyperbaric Oxygen and Combination Therapy in Refractory Sudden Sensorineural Hearing Loss

Yang¹,

Wu²,

Hwang³

2013

Otology &Amp; Neurotology

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Section: Discussionmentioning

confidence: 98%

Comparison of Intratympanic Steroid Injection, Hyperbaric Oxygen and Combination Therapy in Refractory Sudden Sensorineural Hearing Loss

Yang¹,

Wu²,

Hwang³

2013

Otology &Amp; Neurotology

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“…Fu et al [2011] conducted a prospective study of patients with profound SSNHL (PTA > 90 dB). The patients were separated into an IT group and a control group.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Concurrent or Sequential Intravenous and Intratympanic Steroid for Idiopathic Sudden Sensorineural Hearing Loss

Chu¹,

Chiou²,

Wang³

et al. 2018

Audiol Neurotol

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Objective: The purpose of this retrospective study was to investigate the difference in treatment outcomes for patients with idiopathic sudden sensorineural hearing loss (SSNHL) undergoing concurrent or sequential intravenous (IV) and intratympanic (IT) steroid therapies. Methods: Patients with idiopathic SSNHL admitted to Taipei Veterans Hospital from August 2011 to August 2012 were enrolled. Patients were treated with both IV dexamethasone 5 mg b.i.d. for 5 days, then tapered over 6 days, and IT injections of dexamethasone 5 mg daily. The administration of IV and IT steroids was given either concurrently or sequentially (IV steroid was administered from days 1–5 followed by IT steroid treatment starting on day 4 or day 5). The hearing outcomes of the concurrent and sequential groups were analyzed. Results: Overall, after ≥2 months following treatment, across frequencies ranging from 250 to 8,000 Hz and pure-tone average (PTA) assessments, hearing improvements were similar between treatment groups, except at the frequencies of 4,000 and 8,000 Hz where the concurrent treatment group had greater hearing gain than the sequential group (4,000 Hz: 30.68 ± 28.96 vs. 14.52 ± 24.06 dB, respectively, p = 0.042; 8,000 Hz: 22.62 ± 23.59 vs. 7.67 ± 21 dB, p = 0.030). Across frequencies and PTA assessments, a similar percentage of patients had ≥20-dB gains in hearing compared with patients treated sequentially, except at 8,000 Hz where a greater percentage of patients in the concurrent group (57.1%) than the sequential group (23.3%) (p = 0.014) had ≥20-dB hearing gains. Conclusion: The findings suggest that both concurrent and sequential treatment improve hearing in patients with idiopathic SSNHL, and that concurrent treatment may show greater benefit than sequential therapy, particularly at high frequencies.

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“…Not only the severity of hearing loss, but also the configuration of the initial audiograms appears to affect the outcome (20,22). It is suggested that patients with low-frequency hearing losses -upward sloping audiograms -or mid-frequency hearing losses -flat type audiograms -may have a better prognosis (21)(22)(23). It was also suggested that low-frequency hearing losses tend to have better recoveries as they have a better tolerance of impairment (24).…”

Section: Discussionmentioning

confidence: 99%

“…Another possible mechanism explaining why patients with low-frequency loss were more likely to recover is differences in the vulnerability of hair cells. Hair cells in the basal turn are known to be more susceptible to ototoxic drugs and noise than those in the apex (23,24). Therefore, despite having more glucocorticoid receptors, basal turn damage -known as high-frequency losses -have a worse prognosis (24).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Sudden Sensorineural Hearing Loss

Atay¹,

Kayahan²,

Çınar³

et al. 2016

Balkan Med J

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Background: Sudden sensorineural hearing loss (SSNHL) is still a complex and challenging process which requires clinical evidence regarding its etiology, treatment and prognostic factors. Therefore, determination of prognostic factors might aid in the selection of proper treatment modality. Aims: The aim of this study is to analyze whether there is correlation between SSNHL outcomes and (1) systemic steroid therapy, (2) time gap between onset of symptoms and initiation of therapy and (3) audiological pattern of hearing loss. Study Design: Retrospective chart review. Methods: Patients diagnosed at our clinic with SSNHL between May 2005 and December 2011were reviewed. A detailed history of demographic features, side of hearing loss, previous SSNHL and/or ear surgery, recent upper respiratory tract infection, season of admission, duration of symptoms before admission and the presence of co-morbid diseases was obtained. Radiological and audiological evaluations were recorded and treatment protocol was assessed to determine whether systemic steroids were administered or not. Treatment started ≤5 days was regarded as "early" and >5 days as "delayed". Initial audiological configurations were grouped as "upward sloping", "downward sloping", "flat" and "profound" hearing loss. Significant recovery was defined as thresholds improved to the same level with the unaffected ear or improved ≥30 dB on average. Slight recovery was hearing improvement between 10-30dB on average. Hearing recovery less than 10 dB was accepted as unchanged. Results: Among the 181 patients who met the inclusion criteria, systemic steroid was administered to 122 patients (67.4%), whereas 59 (32.6%) patients did not have steroids. It was found that steroid administration did not have any statistically significant effect in either recovered or unchanged hearing groups. Early treatment was achieved in 105 patients (58%) and 76 patients (42%) had delayed treatment. Recovery rates were no different in these two groups; however, when unchanged hearing rates were compared, it was statistically significantly lower in the early treatment group (p<0.05). When hearing outcomes were compared according to initial audiological pattern, significant recovery and unchanged hearing rates did not differ between groups; however, slight recovery rate was highest in the "flat" type audiological configuration (p<0.05). Conclusion: According to this patient series, oral steroid therapy does not have any influence on the outcomes of SSNHL. However, mid-frequency hearing loss of flat type and initiation of treatment earlier than 5 days from the onset of symptoms, seem to have positive prognostic effects. Further randomized controlled subject groups might contribute to determine prognostic factors of SSNHL.

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Intratympanic dexamethasone as initial therapy for idiopathic sudden sensorineural hearing loss: Clinical evaluation and laboratory investigation

Cited by 36 publications

References 19 publications

Comparison of Intratympanic Steroid Injection, Hyperbaric Oxygen and Combination Therapy in Refractory Sudden Sensorineural Hearing Loss

Comparison of Intratympanic Steroid Injection, Hyperbaric Oxygen and Combination Therapy in Refractory Sudden Sensorineural Hearing Loss

The Efficacy of Concurrent or Sequential Intravenous and Intratympanic Steroid for Idiopathic Sudden Sensorineural Hearing Loss

Prognostic Factors in Sudden Sensorineural Hearing Loss

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