DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20173657

Management of sudden sensorineural hearing loss: a prospective study of 30 patients

Sunil N. Khot, Priyadarshini G., Ayisha Kunnumal

Abstract


Background: Sudden sensorineural hearing loss (SNHL) is sensorineural hearing loss of 30 dB or more over at least three contiguous audiometric frequencies that develop over a period of few hours to three days. The purpose of study is to make a protocol for treatment.

Methods: 30 cases of sudden SNHL who presented to OPD of Government Medical College, Miraj between December 2015 to April 2017 were included. Detailed history taking and ENT examination was done. All patients were admitted and started on intravenous methylprednisolone. If hearing improvement was not observed, intratympanic methylprednisolone (ITS) was administered.  

Results: 50% patients had recovery with intravenous Methylprednisolone and 50% had no recovery. “No recovery” patients were subjected to ITS, of which 20% had complete, 30% partial and 50% no recovery. Among no recovery patients of ITS, 10% had hearing loss greater than 90 dB with improvement rate of 0%; 40% had hearing loss of 90 - 50 dB with improvement rate of 50%; 50% had hearing loss of 50-30 dB with improvement rate of 60%. Among 15 cases of ITS, mean number of days between onset of symptom and starting ITS was 13 days for complete recovery patients; 17.3 days for partial or slight recovery; 20.6 days for no recovery.

Conclusions: Hearing loss less than 90 dB and earlier ITS has positive influence on hearing recovery. Systemic steroids are currently the mainstay of initial treatment. ITS is an effective treatment modality for patients who fail to respond to systemic steroids.


Keywords


Sudden sensorineural hearing loss, Intratympanic steroid injection

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References


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

Zadeh MH, Storper IS, Spitzer JB. Diagnosis and treatment of sudden-onset sensorineural hearing loss: a study of 51 patients. Otolaryngol Head Neck Surg. 2003;128(1):92-8.

Psifidis AD, Psillas GK, Daniilidis JC. Sudden sensorineural hearing loss: long-term follow-up results. Otolaryngol Head Neck Surg. 2006;134(5):809-15.

Levie P, Desgain O, de Burbure C, Germonpré P, Monnoye J, Thill M, et al. Sudden hearing loss. B ENT. 2007;3:33.

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(12):772-6.

Moskowitz D, Lee KJ, Smith HW. Steroid use in idiopathic sudden sensorineural hearing loss. Laryngoscope. 1984;94(5):664-6.

Chandrasekhar SS. Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otol Neurotol. 2001;22(1):18-23.

Ho GM, Lin HC, Shu MT, Yang CC, Tsai HT. Effectiveness of intratympanic dexamethasone injection in sudden-deafnesspatients as salvage treatment. Laryngoscope. 2004;114:1184-9.

Erdur O, Kayhan FT, Cirik AA. Effectiveness of intratympanic dexamethasone for refractory sudden sensorineural hearing loss. European Arch Oto-Rhino-Laryngol. 2014;271(6):1431-6.

Purushothaman G, Purushothaman P K, Simham S. A retrospective study of the clinical characteristics and post-treatment hearing outcome in idiopathic sudden sensorineural hearing loss. Audiol Res. 2017;7(1):168.

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

Veldmann JE, Hanada T, Meeuwsen F. Diagnostic and therapeutic dilemmas in rapidly progressive sensorineural hearing loss and sudden deafness. Acta Oto- laryngol (Stockh). 1993;113:303-6.

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

Ferri E, Frisina A, Fasson AC, Armato E, Spinato G, Amadori M. Intratympanic Steroid Treatment for Idiopathic Sudden Sensorineural Hearing Loss after Failure of Intravenous Therapy. ISRN Otolaryngol. 2012;647271:6.

Ahn JH, Yoo MH, Yoon TH, Chung JW. Can Intratympanic Dexamethasone Added to Systemic Steroids Improve Hearing Outcome in Patients With Sudden Deafness. Laryngoscope. 2008;118:279–82.