Intratympanic Steroids for Idiopathic Sudden Sensorineural Hearing Loss

Fitzgerald, Dennis C.; McGuire, John F.

doi:10.1177/000348940711600405

Cited by 47 publications

(34 citation statements)

References 25 publications

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“…The use of intratympanic steroids as a primary treatment is limited to case series and success rates similar to oral therapy have been reported [33,34].…”

Section: Discussionmentioning

confidence: 99%

Efficacy comparison of oral steroid, intratympanic steroid, hyperbaric oxygen and oral steroid + hyperbaric oxygen treatments in idiopathic sudden sensorineural hearing loss cases

Alimoğlu

İnci

Edızer

et al. 2011

Eur Arch Otorhinolaryngol

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Idiopathic sudden sensorineural hearing loss is a rare disorder of unknown pathogenesis in which hearing is lost partially or totally. About 60 treatment modalities have been described. We aimed to compare the efficacy of hyperbaric oxygen, oral steroid, intratympanic steroid therapy and their combinations in idiopathic sudden sensorineural hearing loss patients. Files of patients who were followed up between 2004 and 2010 in our clinic were examined retrospectively. Patients were divided into four groups according to the therapy received: Oral steroid, oral steroid + hyperbaric oxygen, intratympanic steroid and hyperbaric oxygen. Treatment success was assessed by Siegel criteria and mean gains using pre-treatment and post-treatment audiograms. 217 patients and 219 ears were examined. The proportion of patients responding to therapy was the highest in the oral steroid + hyperbaric oxygen group with 86.88% (53/61) followed by the oral steroid group with 63.79% (37/58), the intratympanic steroid group with 46,51% (20/43) and the hyperbaric oxygen group with 43.85% (25/57). The proportion of patients who had complete recovery was the highest in the oral steroid + hyperbaric oxygen group with 42.6% (26/61) followed by the oral steroid group with 19.0% (11/58), the hyperbaric oxygen group with 17.5% (10/57) and the intratympanic steroid group with 11.6% (5/43). The oral steroid + hyperbaric oxygen group has the highest mean hearing gain among all groups (p < 0.05). Idiopathic sudden sensorineural hearing loss patients receiving oral steroid + hyperbaric oxygen combination therapy have a higher likelihood of recovery than patients receiving oral steroids, hyperbaric oxygen or intratympanic steroids alone.

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“…The use of intratympanic steroids as a primary treatment is limited to case series and success rates similar to oral therapy have been reported [33,34].…”

Section: Discussionmentioning

confidence: 99%

Efficacy comparison of oral steroid, intratympanic steroid, hyperbaric oxygen and oral steroid + hyperbaric oxygen treatments in idiopathic sudden sensorineural hearing loss cases

Alimoğlu

İnci

Edızer

et al. 2011

Eur Arch Otorhinolaryngol

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“…In fact, the success rates of intratympanic steroid injection as a salvage treatment option are highly variable, ranging from 12 to 100% [4,[7][8][9][10][11][12][13]. Recently, moreover, initial intervention of intratympanic steroid injection within 14 days of onset has been shown to be effective in hearing recovery in SSNHL patients [14]. On contrary, from Ahn et al's [15] study, the addition of intratympanic steroid injection to systemic steroids did not result in significant improvements in the treatment of SSNHL.…”

Section: Introductionmentioning

confidence: 99%

The efficiency of intratympanic dexamethasone injection as a sequential treatment after initial systemic steroid therapy for sudden sensorineural hearing loss

Lee

Choi

Park

et al. 2011

Eur Arch Otorhinolaryngol

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The effect of intratympanic steroid injection is controversial as salvage or initial treatment option for sudden sensorineural hearing loss (SSNHL) and almost unknown if it is consecutively to use after initial systemic steroids. This study aimed to analyze the efficiency of intratympanic dexamethasone injection (ITDI) as a sequential treatment in the patients who failed initial systemic steroid treatments for SSNHL. Forty-six patients with SSNHL who did not respond to initial systemic steroids were prospectively included in the study. The patients were randomly classified into two groups; the ITDI group (21 patients) did not take four sequential ITDI within 2 weeks after systemic steroids, and the control group (25 patients) took any more medications. Hearing improvement was defined as a 10 dB or more decrease in the pure tone average (PTA) of the four-frequencies (0.5, 1, 2, and 3 kHz). Hearing improvement was observed in 10 (47.6%) of 21 ITDI patients and in 4 (16.0%) of 25 control patients (P = 0.027). An improvement of the mean PTA was 11.4 dB in the ITDI group and 1.7 dB in the control group (P = 0.004). The ITDI group showed significant hearing improvement at low frequency (500 Hz) than the control group. The patients with 70 or more dB in PTA before ITDI showed significant hearing improvement than the other patients with better PTAs (P = 0.038). The sequential ITDI, which is performed immediately after initial systemic steroid therapy, may be a simple, effective second-line treatment of choice for the patients who show poor response to initial treatments for SSNHL.

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“…22 Fitzgerald and McGuire performed intratympanic steroid as a primary treatment in patients with SHL. 23 They obtained 90% success when they performed it in the early period (in 14 days) of hearing loss, while they obtained 40% success in the late phase (after 14 days). 23 In the study of Ahn et al, intratympanic dexamethasone was given as the salvage treatment.…”

Section: Discussionmentioning

confidence: 97%

“…23 They obtained 90% success when they performed it in the early period (in 14 days) of hearing loss, while they obtained 40% success in the late phase (after 14 days). 23 In the study of Ahn et al, intratympanic dexamethasone was given as the salvage treatment. 11 The patients were divided into four groups as follows: Those receiving no further treatment (control group), those receiving intratympanic dexamethasone within 2 weeks (early), between 2 weeks and 1 month (mid), and between 1 and 2 months (late) after initial treatment failure.…”

Section: Discussionmentioning

confidence: 97%

Intratympanic Methyl Prednisolone Salvage Therapy for Sudden Hearing Loss

Hıdır¹,

Genç²,

Durmaz³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of the study was to determine effectiveness of intratympanic methyl prednisolone injection as a salvage therapy for sudden sensorineural hearing loss in patients who did not have complete recovery with systemic treatment. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: Sixteen patients with sudden hearing loss who did not have complete recovery or had a partial recovery with systemic treatment enrolled in this prospective study. After the topical anesthesia, 0.4-0.5 mL of methyl prednisolone (40 mg/mL) was administered into the middle ear from the postero-inferior quadrant of the tympanic membrane. Pure tone audiometry test was performed before each injection and after the final injection. A change more than 10 dB in the pure tone average was considered as an alteration in hearing (improvement or worsening). Complete recovery was accepted when the pure tone average was 20 dB or lower. R Re es su ul lt ts s: : The mean onset of intratympanic methyl prednisolone treatment after the hearing loss was 16±6.6 days (range: 7 -30 days). The average number of injections was 3.8±1.3 (range: 2-6). The improvement in pure tone average was statistically significant [initial median of pure tone average was 85 dB (minimum 28 dB, maximum 107 dB), final median of pure tone averages was 42.5 dB (minimum 12 dB, maximum 107dB), p=0.007]. Eleven (68.75%) patients improved, but no change was observed in 5 (31.25%) patients. Two (12.5%) patients attained complete recovery. Four (25%) patients improved to 30 dB or less in pure tone average. Statistically significant improvement was also obtained at 250, 500, 1,000, 2,000, 4,000 and 6,000 Hz frequencies. C Co on nc cl lu us si io on n: : These results suggested that intratympanic methyl prednisolone treatment for sudden hearing loss in patients who did not respond to systemic therapy appears to be a good alternative for better hearing results. K Ke ey y W Wo or rd ds s: : Hearing loss, sudden; methylprednisolone; salvage therapy; steroids Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, sistemik tedaviye yeterli yanıt alınamayan ani işitme kayıplı hastalarda kurtarma tedavisi olarak uygulanan intratimpanik metil prednizolon tedavisinin etkinliğini araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu prospektif çalışmaya, sistemik tedaviye yanıt alınamayan veya kısmi yanıt alınan 16 ani işitme kayıplı hasta alındı. Topikal anestezi sonrasında 0,4-0,5 mL metil prednizolon (40 mg/mL), timpanik membran posteroinferior kadranından orta kulağa enjekte edildi. Her enjeksiyon öncesinde ve tedavi sonunda saf ses odyometri testi yapıldı. Saf ses ortalamasında 10 desibelden daha fazla değişiklik, değişim olarak kabul edildi (iyileşme veya kötüleşme). Saf ses ortalamasının 20 dB ve daha aşağıdaki değerleri tam iyileşme olarak kabul edildi. B Bu ul lg gu ul la ar r: : İşitme kaybı başlangıcı ile intratimpanik metil prednizolon uygulaması arasındaki ortalama süre 16±6,6 gündü (7-30 gün arasında). Ortalama en...

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Intratympanic Steroids for Idiopathic Sudden Sensorineural Hearing Loss

Abstract: These findings support the use of IT steroids as an early intervention in the treatment of ISSHL.

Cited by 47 publications

References 25 publications

Efficacy comparison of oral steroid, intratympanic steroid, hyperbaric oxygen and oral steroid + hyperbaric oxygen treatments in idiopathic sudden sensorineural hearing loss cases

Efficacy comparison of oral steroid, intratympanic steroid, hyperbaric oxygen and oral steroid + hyperbaric oxygen treatments in idiopathic sudden sensorineural hearing loss cases

The efficiency of intratympanic dexamethasone injection as a sequential treatment after initial systemic steroid therapy for sudden sensorineural hearing loss

Intratympanic Methyl Prednisolone Salvage Therapy for Sudden Hearing Loss

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