Therapeutic Efficacy of the Combination of Intratympanic Methylprednisolone and Oral Steroid for Idiopathic Sudden Deafness

Gündoğan, Onur; Pınar, Ercan; İmre, Abdülkadir; Öztürkcan, Sedat; Cokmez, Ozge; Yigiter, Ali Cihan

doi:10.1177/0194599813500754

Cited by 58 publications

(56 citation statements)

References 20 publications

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“…Of the two studies [22,23] comparing systemic, ITSI and combination therapy, one found that combination therapy was superior to systemic treatment alone (87.5 vs 44.4 %). As for the four remaining studies, three [24][25][26] found that combination therapy was superior to systemic therapy and one [27] favored ITSI over placebo.…”

Section: Resultsmentioning

confidence: 99%

Intratympanic corticosteroids injections: a systematic review of literature

Lavigne

Saliba

2015

Eur Arch Otorhinolaryngol

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The objective of the study was to determine the evidence of intratympanic steroids injections (ITSI) for efficacy in the management of the following inner ear diseases: Ménière's disease, tinnitus, noise-induced hearing loss (NIHL) and idiopathic sudden sensorineural hearing loss (ISSNHL). The data sources were literature review from 1946 to December 2014, PubMed and Medline. A systematic review of the existing literature was performed. Databases were searched for all human prospective randomized clinical trials using ITSI in at least one treatment group. The authors identified 29 prospective randomized clinical trials investigating the benefits of an intratympanic delivery of steroids. Six articles on Ménière's disease were identified, of which one favored ITSI over placebo in vertigo control. Of the five randomized clinical trials on tinnitus therapy, one study found better tinnitus control with ITSI. The only available trial on NIHL showed significant hearing recovery with combination therapy (ITSI and oral steroids therapy). Seventeen studies were identified on ISSNHL, of which 10 investigated ITSI as a first-line therapy and 7 as a salvage therapy. Studies analysis found benefits in hearing recovery in both settings. Due to heterogeneity in treatment protocols and follow-up, a meta-analysis was not performed. Given the low adverse effects rates of ITSI therapy and good patient tolerability, local delivery should be considered as an interesting adjunct to the therapy of the ISSNHL and NIHL. Only one article over six where ITSI therapy offers potential benefits to patients with Ménière's disease in the control of tinnitus and vertigo was found. ITSI does not seem to be effective in the treatment of tinnitus.

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Section: Resultsmentioning

confidence: 99%

Intratympanic corticosteroids injections: a systematic review of literature

Lavigne

Saliba

2015

Eur Arch Otorhinolaryngol

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“…The final logistic regression model suggests that IT-dexa may be a predictor of recovery after treatment in case of patients with SSNHL. Gundogan et al [13] also reported that combined therapy is more effective than oral steroid monotherapy in hearing outcome of patients with severe hearing loss. Additionally, Gunel et al [14] reported that 87.5% of patients who were initially treated with an intratympanic steroid showed full recovery (Siegel's criteria type 1).…”

Section: Discussionmentioning

confidence: 99%

Questionnaires in Patients with Unilateral Sudden Sensorineural Hearing Loss

Hwang

Joo²,

Song³

et al. 2017

Int Adv Otol

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OBJECTIVE:In this study, we evaluated the prognostic value of the Dizziness Handicap Inventory (DHI) and the Tinnitus Handicap Inventory (THI) in patients with unilateral sudden sensorineural hearing loss (SSNHL). MATERIALS and METHODS:In total, 101 patients with unilateral SSNHL (44 women, 57 men), who were admitted and treated at our institution between December 2012 and June 2014, were included in the study. All patients completed the questionnaires for DHI and THI during their admission and were treated with bed rest and oral methylprednisolone (1 mg/kg, which was eventually tapered). Of these, 83 patients received intratympanic dexamethasone 4 times over a 2-week period. Demographic data, accompanying symptoms, and DHI and THI subscales were compared between the non-recovery group (Siegel's criteria type 4, n=63) and the recovery group (Siegel's criteria type 1-3, n=38). RESULTS:There were no significant differences between the two groups with regard to gender, hypertension, diabetes mellitus, cerebrovascular attack, and tinnitus. Patients in the non-recovery group were significantly older (51.53 vs. 50.24 years, p<0.05) and had a higher incidence of chronic kidney disease (10.53% vs. 1.59%, p<0.05) than those in the recovery group. Although more patients in the non-recovery group complained of dizziness (47.37% vs. 25.40%, p<0.05), DHI subscales were not significantly different between the groups. THI subscales were also not significantly different between the two groups.CONCLUSION: DHI and THI questionnaires may have limited prognostic value for patients with unilateral SSNHL.

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“…Although the efficacy of steroids in ISSNHL is still conflicting irrespective of the delivery method, recent previous studies found that combined steroid treatment (systemic steroid+ITS) provides better hearing recovery than systemic steroid alone. [6,7] Suzuki et al reported that systemic plus intratympanic steroid administration is more effective than systemic steroid plus HBO therapy. [19] It is believed that the diffusion of higher steroid concentration into cochlear fluids reduces inflammation in the inner ear.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, data from three randomized controlled studies showed the benefit of combination therapy, especially in patients with mild-to-severe hearing loss. [6][7][8] In our institution, we have been preferring combination therapy as the initial management for ISSNHL and HBO therapy as salvage or adjuvant therapy after failure of combination therapy since 2013.…”

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confidence: 99%