DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20220799

Clinicoaudiological evaluation of hearing improvement in patients with sensorineural hearing loss using intratympanic platelet rich plasma versus steroid injection

Stephy Maria Tom, Kavita Sachdeva, Mayur V. Kabade, Amrita Shukla, Lakshmy V. Raj

Abstract


Background: SNHL is a heterogenous disorder, which can arise due to damage to pathway for sound impulses from the hair cells of inner ear to auditory nerve. This study is to evaluate and compare the effect of intratympanic instillation of PRP in patients having sensorineural hearing loss with steroid therapy.

Methods: A prospective observational study carried out in the department of ENT, NSCB medical college Jabalpur. The cases were selected who presented with sensorineural hearing loss and mixed hearing loss with intact TM. Total of 54 cases were enrolled in the study from 1March, 2020 to 31 August 2021.Preoperative PTA was recorded. 0.5 ml of intratympanic platelet rich plasma and 0.5 ml of steroid dexamethasone administered. Postoperative PTA was done after 15 days of intratympanic injection and results recorded.

Results: In our study the mean age of the participants was 40.4 years. Bilateral and gradual hearing loss were common in the present study. The improvement from baseline to follow up period was higher in PRP group compared to DEXA group. It is statistically significant (p=0.001). The improvement in hearing loss is decreasing with the increase in age. The study revealed that hearing improvement with PRP is better than steroid.

Conclusions: The study concluded that the hearing improvement was more with single injection of PRP than dexamethasone.


Keywords


Sensorineural hearing loss, Intratympanic, Platelet rich plasma, Steroid

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References


Estimates Prevention of blindness and deafness. Available at: http://www.who.int/phd/deafness/ estimates/en/. Accessed on 20 October 2021.

Wake M, Hughes EK, Poulakis Z, Collins C, Rickards FW. Outcomes of children with mild-profound congenital hearing loss at 7 to 8 years: A population study. Ear Hear. 2004;25(1):1-8.

Borton SA, Mauze E, Lieu JEC. Quality of life in children with unilateral hearing loss: a pilot study. Am J Audiol. 2010;19(1):61-72.

Carlsson PI, Hjaldahl J, Magnuson A, Ternevall E, Eden M, Skagerstrand A, et al. Severe to profound hearing impairment: quality of life, psychological consequences and audiological rehabilitation. Disabil Rehabil. 2015;37(20):1849-56.

Cruickshanks KJ, Wiley TL, Klein DK, Klein R, Chappell R, Dalton DS. The 5 year incidence and progression of hearing loss: the epidemiology of hearing loss study. Arch Otolaryngol Head Neck Surg. 2003;129(10):1041-6.

Tyagi BBPS, Mamatarani RM. Platelet rich plasma. A revolutionary treatment of sensorineural hearing loss. Acta Sci Otolaryngol. 2019;4:2-5.

Crane RA, Camilon M, Nguyen S, Meyer TA. Steroids for treatment of sudden sensorineural hearing loss: A meta-analysis of randomized controlled trials. Laryngoscope. 2014;10:1002-5.

Koltsidopoulos P, Bibas A, Sismanis A, Seggas I, Tzonou A. Intratympanic and systemic steroids for sudden hearing loss. Otol Neurotol. 2013;34:771-6.

Arslan N, Oğuz H, Demirci M, Safak MA, Islam A, Kaytez SK, et al. Combined intratympanic and systemic use of steroids for idiopathic sudden sensorineural hearing loss. Otol Neurotol. 2011; 32(3):393-7.

Battaglia A, Burchette R, Cueva R. Combination therapy (intratympanic dexamethasone + high-dose prednisone taper) for the treatment of idiopathic sudden sensorineural hearing loss. Otol Neurotol. 2008;29(4):453-60.

Silverstein H, Choo D, Stein I. Intratympanic steroid treatment of inner ear disease and tinnitus. Ear, Nose Throat J. 1996;75:468-71.

Wei BP, Stathopoulos D, O‘Leary S. Steroids for idiopathic sudden sensorineural hearing loss. Cochrane Collab. 2013;2:12-8.

Brunton LL, Chabner BA, Knollmann BC. Goodman and Gilman‘s The Pharmacologic Basis of Therapeutics. 12th ed. United States of America: McGraw-Hill; 2011.

Bird PA, Begg EJ, Balkany TJ. Intratympanic versus Intravenous delivery of methylprednisolone to cochlear perilymph. Otol Neurotol. 2007;28:1124-30.

Campbell NA. Biology. 8th ed. London: Pearson Education; 2008.

Midwood KS, Williams LV, Schwarzbauer JE. Tissue repair and the dynamics of the extracellular matrix. Int J Biochem Cell Biol. 2004;36:1031-7.

Bielecki TM, Gazdzik TS, Arendt J, Szczpanski T, Krol W, Wielkoszynski T. Antibacterial effect of autologous platelet gel enriched with growth factors and other active substances: an in vito stuy. J Bone Joint Surg Br. 2007;89:417-20.

Ikumi A, Hara Y, Yoshioka T, Kanamori A, Yamazaki M. Effect of local administration of platelet-rich plasma (PRP) on peripheral nerve regeneration: An experimental study in therabbit model‖. Microsurgery. 2017;38(3):23-7.

Küçük L, Gunay H, Erbas O, Kucuk U, Calis FA, Coskunol E. Effects of platelet-rich plasma on nerve regeneration in a rat model. ACTA Orthoped Traumatol Turcica. 2011;48(4):449-54.

Fijnheer R, Pietersz RNI, Korte DD, Gouwerok CWN, Dekker WJA, Reesink HW, et al. Platelet activation during preparation of platelet concentrates: a comparison of the platelet-rich plasma and the buffy coat methods. Transfusion. 1990;30:634-8.

Dohan EDM, Cors DA, Mouhyi J. Three-dimensional architecture and cell composition of a Choukroun‘s platelet rich fibrin clot and membrane‖. J Periodontol. 2010;81:546-55.

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.

Moskowitz D,Lee KJ,Smith HW: Steroid use in idiopathic sudden sensorineural hearing loss. Laryngoscope. 2002;94:664.

Filipo R, Attanasio G, Covelli E. Intratympanic steroid therapy in moderate sudden hearing loss: a randomized, triple-blind, placebo-controlled trial. Laryngoscope. 2013;123:774-8.

Gundogan O, Pinar E, Yigiter AC. Therapeutic Effificacy of the Combination of Intratympanic Methylprednisolone and Oral Steroid for Idiopathic Sudden Deafness. Otolaryngol Head Neck Surg. 2013; 16:23-9.

Arslan N, Oguz H, Samim E. Combined Intratympanic and Systemic Use of Steroids for Idiopathic Sudden Sensorineural Hearing Loss. Otol Neurotol. 2011;32: 393-7.

Lopez E, Bermejo N, Berna-Erro A, Alonso N, Salido GM, Redondo PC, et al. A relationship between calcium mobilization and platelet α- and δ-70 granule secretion. A role for TRPC6 in thrombin-evoked δ-granule exocytosis. Arch Biochem Biophysics. 2015; 585:75-81.

Scully D, Naseem KM, Matsakas A. Platelet biology in regenerative medicine of skeletal muscle. Acta Physiologica (Oxford, England). 2018:e13071.

Sanchez M, Delgado D, Sanchez P, Fiz N, Azofra J, Orive G, et al. Platelet rich plasma and knee surgery. Bio Med Research Int. 2014;2014:890630.

Garate A, Sánchez P, Delgado D, Bilbao AM, Muiños-López E, Granero Moltó F, et al. Autologous bioscaffolds based on different concentrations of platelet rich plasma and synovial fluid as a vehicle for mesenchymal stem cells. J Biomed Mat Res. 2018; 106(2):377-85.

Dohle E, El Bagdadi K, Sader R, Choukroun J, James Kirkpatrick C, Ghanaati S. Platelet-rich fibrin-based matrices to improve angiogenesis in an in vitro co-culture model for bone tissue engineering. J Tissue Eng Reg Med. 2018;12(3):598-610.

Sánchez M, Garate A, Delgado D, Padilla S. Platelet-rich plasma, and adjuvant biological therapy to assist peripheral nerve repair. Neural Reg Res. 2017;12(1): 47-52.

Yu W, Wang J, Yin J. Platelet rich plasma: A promising product for treatment of peripheral nerve regeneration after nerve injury. The Int J Neurosci. 2011;121(4):176-80.

Cho HH, Jang S, Lee SC, Jeong HS, Park JS, Han JY, et al. Effect of neural-induced mesenchymal stem cells and platelet-rich plasma on facial nerve regeneration in an acute nerve injury model. Laryngoscope. 2010; 120(5):907-13.