Intratympanic steroids for combined treatment of idiopathic sudden hearing loss: when is it too late?

Amarillo, Elizabeth; Navarro, Andrés; Hernández‐García, Estefanía; Plaza, Guillermo

doi:10.1080/00016489.2019.1614222

Cited by 10 publications

(5 citation statements)

References 19 publications

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“…This result echoes the findings of a nationwide survey in Japan (Okada et al 2017). As for the effects of treatment delay, there is again no consensus due to the high rate of spontaneous recovery: while some studies argue that each additional day following SSNHL onset will negatively impact recovery (Attanasio et al 2018), others estimate that excellent outcomes are still achieved for delays of up to 2 weeks (Mattox & Simmons 1977;Edizer et al 2015;Amarillo et al 2019) as observed in the present study (Fig. 3F).…”

Section: Steroid Treatment Efficacysupporting

confidence: 85%

Idiopathic Sudden Sensorineural Hearing Loss: Speech Intelligibility Deficits Following Threshold Recovery

et al. 2020

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Objectives: This retrospective study tests the hypothesis that patients who have recovered from idiopathic sudden sensorineural hearing loss (SSNHL) show deficits in word recognition tasks that cannot be entirely explained by a loss in audibility. Design: We reviewed the audiologic profile of 166 patients presenting with a unilateral SSNHL. Hearing loss severity, degree of threshold recovery, residual hearing loss, and word recognition performance were considered as outcome variables. Age, route of treatment, delay between SSNHL onset and treatment, and audiogram configuration were considered as predictor variables. Results: Severity, residual hearing loss, and recovery were highly variable across patients. While age and onset-treatment delay could not account for the severity, residual hearing loss and recovery in thresholds, configuration of the SSNHL and overall inner ear status as measured by thresholds on the contralateral ear were predictive of threshold recovery. Speech recognition performance was significantly poorer than predicted by the speech intelligibility curve derived from the patient’s audiogram. Conclusions: SSNHL is associated with (1) changes in thresholds that are consistent with ischemia and (2) speech intelligibility deficits that cannot be entirely explained by a change in hearing sensitivity.

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Section: Steroid Treatment Efficacysupporting

confidence: 85%

Idiopathic Sudden Sensorineural Hearing Loss: Speech Intelligibility Deficits Following Threshold Recovery

et al. 2020

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“…Large doses of corticosteroids are considered necessary to elicit the efficacy of corticosteroids for inner ear pathology because the more systemic corticosteroids are prescribed, the more corticosteroids reach the inner ear (21). Initial treatment, especially sufficient corticosteroid administration in the early stage of onset, would make a significant contribution to hearing recovery, considering starting treatment within 7 days of onset is associated with a good prognosis (2) and the effectiveness of treatment is less likely to be obtained after 2 weeks of onset as consistent with previous reports (22). The comparable final hearing outcome in the repetitive-treatment group and the single-treatment group may be the result of the initial corticosteroid administration with a time lag.…”

Section: Discussionsupporting

confidence: 70%

Is repetitive systemic corticosteroid therapy effective for idiopathic sudden sensorineural hearing loss? a retrospective study

et al. 2023

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IntroductionSome idiopathic sudden sensorineural hearing loss (ISSHL) cases experience repetitive systemic corticosteroid treatment, but studies focusing on repetitive systemic corticosteroid administration have not been reported. Thus, we investigated the clinical characteristics and usefulness of repetitive systemic corticosteroid treatment in ISSHL cases.MethodsWe reviewed the medical records of 103 patients who received corticosteroids only in our hospital (single-treatment group), and 46 patients who presented at our hospital after receiving corticosteroids in a nearby clinic and were subsequently treated with corticosteroids again in our hospital (repetitive-treatment group). Clinical backgrounds, hearing thresholds, and hearing prognosis were assessed.ResultsThe final hearing outcomes were not different between the two groups. Further, in the repetitive-treatment group, statistical differences were found between the good and poor prognosis groups in the number of days to start corticosteroid administration (p = 0.03), the dose of corticosteroid (p = 0.02), and the duration of corticosteroid administration (p = 0.02) at the previous facility. Multivariate analysis revealed a significant difference in the dose of corticosteroids administered by the previous clinic (p = 0.004).ConclusionThe repetitive systemic corticosteroid administration might play a supplementary role in hearing improvement, and initial sufficient corticosteroid administration would lead to good hearing outcomes in an early phase of ISSHL.

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“…The characteristic symptom of idiopathic sudden sensorineural hearing loss (ISSNHL) is abrupt unilateral deafness with a rapid onset of more than 30 dB HL at 3 consequential frequencies over the course of 3 days. 1 …”

Section: Introductionmentioning

confidence: 99%

Discriminant Analysis of the Prognostic Factors for Hearing Outcomes in Patients with Idiopathic Sudden Sensorineural Hearing Loss

Askar¹,

Ghonim²,

Shabana³

2023

Int Adv Otol

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BACKGROUND: This study aims to determine and assess prognostic variables that might affect the hearing result in patients with idiopathic sudden sensorineural hearing loss following intratympanic steroid injection. Methods: In total, 190 patients with idiopathic sudden sensorineural hearing loss received intratympanic steroid injection. Two hearing indices (recovery and nonrecovery) will be analyzed as dependent variables; patient’s age, time period between the onset of hearing loss and treatment, initial level of hearing (hearing loss pre), type of audiogram curve (upsloping, downsloping, and flat), presence of vertigo, presence of tinnitus, and diabetes) will be analyzed as prognostic factor variables. Results: Recovery was seen in 72% of the patients. Different preinjection audiogram curves and hearing grades had a significant effect on recovery, absence of vestibular symptoms and no diabetic history were noted to have a good prognosis. Delay in treatment by more than 30 days from the onset of hearing loss was associated with a worse prognosis. Conclusion: Idiopathic sudden sensorineural hearing loss associated with late treatment plan more than 1 month, presence of vertigo, diabetes, and profound prehearing loss were negative prognostic factors. Whereas age, gender, and presence of tinnitus did not affect prognosis. More stable response was obtained when intratympanic steroids were added within 1 month after diagnosis, and the patient presented with mild or moderate hearing loss grade, flat or downsloping pure tone audiometery curve, and absence of vertigo and nondiabetic with significantly good results.

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Intratympanic steroids for combined treatment of idiopathic sudden hearing loss: when is it too late?

Cited by 10 publications

References 19 publications

Idiopathic Sudden Sensorineural Hearing Loss: Speech Intelligibility Deficits Following Threshold Recovery

Idiopathic Sudden Sensorineural Hearing Loss: Speech Intelligibility Deficits Following Threshold Recovery

Is repetitive systemic corticosteroid therapy effective for idiopathic sudden sensorineural hearing loss? a retrospective study

Discriminant Analysis of the Prognostic Factors for Hearing Outcomes in Patients with Idiopathic Sudden Sensorineural Hearing Loss

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