Rate of tympanic membrane perforation after intratympanic steroid injection

Topf, Michael C.; Hsu, David; Adams, Douglas R.; Zhan, Tingting; Pelosi, Stanley; Willcox, Thomas O.; McGettigan, Brian; Fisher, Kyle

doi:10.1016/j.amjoto.2016.09.004

Cited by 38 publications

(30 citation statements)

References 27 publications

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“…This is associated with a risk of persistent tympanic membrane perforation, although no perforation of the tympanic membrane was found in any of our animals at 4 weeks after exposure to USMB. A rate of 1.6% was reported for persistent perforation of the tympanic membrane following multiple intratympanic steroid injections (37). Modifying the USMB cavitation settings to reduce the number of the injections may avoid this complication and is another important issue to investigate further.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-induced microbubble cavitation via a transcanal or transcranial approach facilitates inner ear drug delivery

Liao¹,

Wang²,

Weng³

et al. 2020

JCI Insight

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Section: Discussionmentioning

confidence: 99%

Ultrasound-induced microbubble cavitation via a transcanal or transcranial approach facilitates inner ear drug delivery

Liao¹,

Wang²,

Weng³

et al. 2020

JCI Insight

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“…Our lack of TM complications or permanent injury with IT injection was consistent with reports in the literature describing its relative safety. 45 However, because multiple IT injections do add theoretical risk to TM injury and may subsequently impact low-frequency PTA, [46][47][48] the investigation of novel treatments that may decrease the number of necessary IT injections, such as the described migraine prophylactic medications, is important. The lack of TM complications following IT injections in our studied cohort can be attributed to: 1) application of a very small amount of phenol (approximately the size of a 25 Ga needle) on the TM to minimize the chance of Laryngoscope 00: 2020…”

Section: Discussionmentioning

confidence: 99%

Adjuvant Migraine Medications in the Treatment of Sudden Sensorineural Hearing Loss

et al. 2020

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Objectives/Hypothesis: To examine the hearing outcomes of patients with sudden sensorineural hearing loss (SSNHL) treated with oral and intratympanic (IT) steroid only or a combination of steroid and migraine treatment. Our hypothesis was that adjuvant migraine medications may improve outcomes in SSNHL. Methods: A retrospective chart review at a tertiary otology center was conducted to identify patients with SSNHL who received oral steroid and IT dexamethasone injection(s) with or without migraine medications (a combination of nortriptyline and topiramate). Results: A total of 47 patients received oral steroid and IT dexamethasone injection(s) only, and 46 patients received oral steroid and IT dexamethasone injection(s) as well as migraine lifestyle changes plus a combination of nortriptyline and topiramate. There were no significant differences in demographics and baseline audiometric data between the two groups. Both groups demonstrated improvements in pure tone average (PTA) and hearing thresholds at 250 Hz and 8000 Hz posttreatment. However, compared to steroid-only group, the adjuvant migraine medications group had significantly greater improvements in hearing thresholds at the lower frequencies (250 Hz, 500 Hz, 1000 Hz). Patients in the latter cohort also had greater improvement in PTA (P = .01) and received fewer IT injections (P = .04) PTA improvement of ≥ 10 dB was observed in 36 patients (78%) in the adjuvant migraine medications group and 22 patients (46%) in the control group (P < .001). Conclusion: In multimodal treatment of SSNHL, supplementing oral and IT steroid with migraine medications may result in greater improvements in lower frequency hearing thresholds and PTA. Furthermore, adjuvant migraine treatment can lead to decrease in number of IT injections, thus reducing procedure-related risks and complications.

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“…The most common complication of ITS treatment is persistent tympanic membrane perforation. [21] Among our patients, none had tympanic membrane perforation. In addition, other possible complications such as vertigo, otitis media, and intolerable pain were not observed in our patients.…”

Section: Discussionmentioning

confidence: 65%

The outcome of intratympanic steroid therapy as a salvage treatment for sudden sensorineural hearing loss

Tahir¹

2019

Tr-ENT

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Objectives: The aim of this study is to evaluate the outcomes of intratympanic steroid (ITS) treatment for idiopathic sudden sensorineural hearing loss (SSNHL). Patients and Methods: Between January 2014 and November 2016, medical charts of a total of 63 patients (47 males, 16 females; mean age: 44.2±17.5 years; range, 18 to 77 years) who were hospitalized due to SSNHL were retrospectively analyzed. The patients were divided into two groups as those who received standard treatment (Group 1, n=32) and those who received ITS treatment as a salvage treatment (Group 2, n=31). Treatment modalities and the results of pure tone audiometry tests were recorded. Recovery was assessed according to the Furuhashi criteria. Results: There was no significant difference in the hearing recovery rates between Group 1 and Group 2. In the patients receiving standard treatment, the recovery rate was significant (78%), while it was only 35.4% in the patients receiving ITS treatment (p=0.361). Conclusion: Although recent guidelines strongly recommend ITS treatment, in our study, ITS, which was started on Day 5 of admission, was not found to be superior to standard systemic treatment.

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Rate of tympanic membrane perforation after intratympanic steroid injection

Cited by 38 publications

References 27 publications

Ultrasound-induced microbubble cavitation via a transcanal or transcranial approach facilitates inner ear drug delivery

Ultrasound-induced microbubble cavitation via a transcanal or transcranial approach facilitates inner ear drug delivery

Adjuvant Migraine Medications in the Treatment of Sudden Sensorineural Hearing Loss

The outcome of intratympanic steroid therapy as a salvage treatment for sudden sensorineural hearing loss

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