The role of intratympanic dexamethasone in sudden sensorineural hearing loss

Vivek Samor; Sukhdev Khadav; Pooja Arya; Deepchand .; Ramniwas Dhaka

doi:10.18203/issn.2454-5929.ijohns20201551

Authors

Vivek Samor Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India
Sukhdev Khadav Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India
Pooja Arya Department of ENT, SK Medical College, Sikar, Rajasthan, India
Deepchand . Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India
Ramniwas Dhaka Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20201551

Keywords:

Intratympanic dexamethasone, Sudden sensorineural hearing loss, Audiogram

Abstract

Background: Present study was conducted to assess the efficacy of intratympanic dexamethasone in patients with sudden sensorineural hearing loss and to determine factor affecting treatment outcome for sudden sensorineural hearing loss.

Methods: Prospective study was conducted on 24 patients of sudden sensorineural hearing loss between October 2019 to February 2020 in the department of ENT, OPD, SPMC, Bikaner. Group A were given oral steroids: prednisolone 1 mg/kg/day (maximal dose is 60 mg/day) full dose 14 days, then tapered over next 14 days. Group B were given intratympanic dexamethasone 4 mg/ml, 0.5 ml into middle ear space (into the posterior inferior quadrant) every 7 days for a total of 4 weeks. Audiogram was performed at end of every week for 4 weeks.

Results: Overall, 58% (n=14) patients showed improvement in pure-tone average. For ≤3 days of presentation; out of total 6 patients, 83.33% cases recovered. For 4 to 7 days of presentation; out of total 10 patients, 80% cases recovered. For 8 to 14 days presentation; out of total 8 patients 12.5% cases recovered (p=0.005).

Conclusions: We suggest the treatment approach in which interaural time difference is used adjuvantly with oral steroids.

Metrics

Metrics Loading ...

References

Wilson WR, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double blind clinical study. Arch Otolaryngol. 1980;106:772-6.

Chen CY, Halpin C, Rauch SD. Oral steroid treatment of sudden sensorineural hearingloss: a ten year retrospective analysis. Otol Neurotol. 2003;24:728-33.

Mattox DE, Lyles CA. Idiopathic sudden sensorineural hearing loss. Am J Otol. 1989;10(3):242-7.

Byl FM. Sudden hearing loss: eight years experience and suggested prognostic table. Laryngoscope. 1984;94 (5):647-61.

Slattery WH, Fisher LM, Iqbal Z, Liu N. Oral steroid regimens for idiopathic sudden sensorineural hearing loss. Otolaryngol Head Neck Surg. 2005;132:5-10.

Cinamon U, Bendet E, Kronenberg J. Steroids, carbogen or placebo for sudden hearing loss: a prospective double-blind study. Eur Arch Otorhinolaryngol. 2001;258:477-80.

Humes LE. The World Health Organization's hearing-impairment grading system: an evaluation for unaided communication in age-related hearing loss. Int J Audiol. 2019;58(1):12-20.

Slattery WH, Fisher LM, Iqbal Z, Friedman RA, Liu N. Intratympanic steroid for the treatment of sudden hearing loss. Otolaryngol Head Neck Surg. 2005;133:251-9.

Haynes DS, O’Malley M, Cohen S, Watford K, Labadie RF. Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy. Laryngoscope. 2007;117(1):3-15.

Chandrasekhar SS. Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otol Neurotol. 2001;22:18-23.

Gianoli GJ, Li JC. Transtympanic steroids for treatment of sudden hearing loss. Otolaryngol Head Neck Surg. 2001;125:142-6.

Moskowitz D, Lee KJ, Smith HW. Steroid use in idiopathic sudden sensorineural hearing loss. Laryngoscope. 1984;94:664-6.

Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol. 1977;86:463-80.

Fuse T, Aoyagi M, Funakubo T, Sakakibara A, Yoshida S. Short-term outcome and prognosis of acute low-tone sensorineural hearing loss by administration of steroid. ORL J Otorhinolaryngol Relat Spec. 2002;64(1):6-10

Lefebvre PP, Staecker H. Steroid perfusion of the inner ear for sudden sensorineural hearing loss after failure of conventional therapy: a pilot study. Acta Otolaryngol. 2002;122:698-702.