Prediction of hearing recovery in sudden deafness treated with intratympanic steroids

Attanasio, Giuseppe; Russo, Francesca; Porto, Edoardo Di; Cagnoni, Laura; Masci, Eleonora; Ralli, Massimo; Greco, Antonio; Vincentiis, Marco de

doi:10.14639/0392-100x-1614

Cited by 14 publications

(12 citation statements)

References 33 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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“…Steroid therapy, defibrase administration, and hyperbaric oxygen therapy have been reported as treatment methods. [1][2][3][4][5][6][7][8] A probability of recovery without these treatments has also been reported. 23 Although systemic steroid therapy is the most common treatment, it poses the risk of side effects such as high blood pressure, hyperglycemia, gastric ulcers, and susceptibility to infections.…”

Section: Discussionmentioning

confidence: 99%

“…Although its pathogenesis remains unclear, systemic administration of glucocorticoid steroids, intratympanic steroids, defibrase, and hyperbaric oxygen is proposed treatment methods. [1][2][3][4][5][6][7][8] These treatment methods have been observed to have some effectiveness; however, the success rates remain low. The commonly used treatment involves the oral or intravenous administration of glucocorticoid steroids; however, systemic steroid therapy may cause various complications, such as hypertension, hyperglycemia, and acute gastric mucosal ulcers.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Intratympanic Glucocorticoid Steroid Administration Therapy as an Initial Treatment for Idiopathic Sudden Sensorineural Hearing Loss During the COVID-19 Pandemic

et al. 2021

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Objective: Systemic administration of glucocorticoid steroids is the most common initial treatment for idiopathic sudden sensorineural hearing loss (ISSNHL); however, due to the prevalence of coronavirus disease, the indications for this treatment must be carefully determined. The aim of this study was to investigate the efficacy of intratympanic steroid therapy as an initial treatment for idiopathic SSNHL. Methods: Sixty-eight patients with idiopathic ISSNHL who were treated with intravenous or intratympanic steroids were included in this study. Patients were retrospectively evaluated regarding preoperative grade, type of additional treatment, outcome of treatment, and side effects of each treatment. Results: In 46 cases, patients received intravenous steroid therapy as the initial treatment, while 22 patients received intratympanic steroid therapy; 10 patients underwent salvage treatment due to inadequate improvement of symptoms. Regarding additional treatment, intravenous steroid monotherapy was used in 37 patients. The outcomes were similar after both treatments; 16 (43%) and 11 (52%) patients treated exclusively with intravenous and intratympanic steroids, respectively, were completely cured. There were no significant differences in the effects between the 2 treatments, indicating that they were almost equally effective. The side effects observed in patients treated with intravenous steroid therapy were increased blood pressure, acute gastric mucosal disorder, and insomnia. None of these side effects were observed in any of the patients treated with intratympanic steroids; however, 1 case of perforation of the tympanic membrane occurred due to the procedure. Conclusion: There were no significant differences in posttreatment outcomes between patients treated with either intratympanic or intravenous steroids. The therapeutic effects were comparable, and no severe side effects were observed; therefore, intratympanic steroid therapy may be considered useful as an initial treatment for ISSNHL in the context of widespread coronavirus disease.

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“…This study found that there is no significant difference in the effect of course on hearing prognosis. Attanasio et al ( 16 ) believed that with the extension of the course in ISSNHL patients, the success rate of hearing prognosis decreased gradually. We believed that the reason for this result was that the chi-square test only considered the course of disease itself which did not take other factors into account.…”

Section: Discussionmentioning

confidence: 99%

Systemic steroid administration combined with intratympanic steroid injection in the treatment of a unilateral sudden hearing loss prognosis prediction model: A retrospective observational study

Yuan

Liu²,

Ma³

et al. 2022

Front. Neurol.

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Idiopathic sudden sensorineural hearing loss (ISSNHL) is an emergency ear disease that is referred to as a sensorineural hearing loss of at least 30 dB in three sequential frequencies and occurs over a period of < 72 h. Because of its etiology, pathogenesis, and prognostic factors, the current treatment methods are not ideal. Previous studies have developed prognostic models to predict hearing recovery from ISSNHL, but few studies have incorporated serum biochemical indicators into previous models. The aim of this study was to explore the factors influencing the ISSNHL prognosis of combination therapy (combined intratympanic and systemic use of steroids, CT), among the patient population data, the serum biochemical indicators before the treatment, and the clinical features of ISSNHL. The new prediction model was developed through these factors. From November 2015 to April 2022, 430 patients who underwent CT at the Department of Otorhinolaryngology Head and Neck Surgery, Tangdu Hospital, Air Force Medical University for ISSNHL, were reviewed retrospectively. We found significant differences in age (P = 0.018), glucose (P = 0.035), white blood cell (WBC) (P = 0.021), vertigo (P = 0.000) and type (P = 0.000) with different therapeutic efficacies. Multivariate logistic regression analysis showed that age (OR = 0.715, P = 0.023), WBC (OR = 0.527, P = 0.01), platelet to lymphocyte ratio (PLR) (OR = 0.995, P = 0.038), vertigo (OR = 0.48, P = 0.004), course (time from onset to treatment) (OR = 0.681, P = 0.016) and type (OR = 0.409, P = 0.000) were independent risk factors for ISSNHL prognosis. Based on independent risk factors, a predictive model and nomogram were developed to predict hearing outcomes in ISSNHL patients. The area under the curve (AUC) value of the model developed in this study was 0.773 (95% CI = 0.730–0.812), which has a certain predictive ability. The calibration curve indicated good consistency between the actual diagnosed therapeutic effectiveness and the predicted probability. The model and nomogram can predict the hearing prognosis of ISSNHL patients treated with CT and can provide help for medical staff to make the best clinical decision. This study has been registered with the registration number ChiCTR2200061379.

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Prediction of hearing recovery in sudden deafness treated with intratympanic steroids

Cited by 14 publications

References 33 publications

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

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

Efficacy of Intratympanic Glucocorticoid Steroid Administration Therapy as an Initial Treatment for Idiopathic Sudden Sensorineural Hearing Loss During the COVID-19 Pandemic

Systemic steroid administration combined with intratympanic steroid injection in the treatment of a unilateral sudden hearing loss prognosis prediction model: A retrospective observational study

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