Transtympanic steroids for treatment of sudden hearing loss
ABSTRACT To determine whether transtympanic steroid administration may be an effective treatment for sudden onset sensorineural hearing loss (SSNHL) in patients for whom systemic steroid treatment has failed or who were not candidates for systemic steroids.
The standard medical regimen for SSNHL usually involves systemic steroid therapy. Unfortunately, some patients do not respond successfully to or are poorly tolerant of systemic steroids. Transtympanic administration of steroids has been suggested as an alternative to systemic therapy. A prospective study was designed to evaluate the hearing outcomes in SSNHL patients treated with transtympanic steroids. Patients received transtympanic steroids if oral steroids had failed to work or if they were not able to tolerate oral steroids. Transtympanic steroids were administered through a ventilation tube placed with the patient under local anesthesia. Steroid administration was performed on 4 separate occasions over the course of 10 to 14 days. Hearing was assessed immediately before therapy and within 1 to 2 weeks after therapy.
Hearing improvement was documented in 10 of 23 patients (44%) who underwent transtympanic steroid administration. This represents a 44% hearing salvage in patients for whom steroid treatment would otherwise have been considered a failure.
Transtympanic steroid therapy may be an alternative treatment for patients with SSNHL for whom systemic steroid therapy had failed or who could not tolerate systemic steroid therapy.
- SourceAvailable from: Rachael T Richardson[Show abstract] [Hide abstract]
ABSTRACT: To study electric acoustic stimulation, we have developed a model of guinea pig cochlear implantation via a cochleostomy. Thirty minutes prior to implantation, a hyaluronic acid/carboxymethylcellulose bead, loaded with either dexamethasone or normal saline, was placed upon the round window membrane. Animals that did not receive beads acted as controls. Pure-tone auditory brainstem response thresholds were estimated before and after electrode insertion, and 1 and 4 weeks later. Selected cochlear histology was performed. RESULTS: Dexamethasone could be detected in the cochlea for 24 h after cochlear implantation. Thresholds were elevated across frequencies in all animals immediately after surgery. These thresholds recovered completely at and below 2 kHz, and partially at higher frequencies by 1 week after implantation. At 32 kHz, but not the lower frequencies, the presence of dexamethasone had a significant protective effect upon hearing, which increased in magnitude over time. The protection was greatest in difficult implantations where an intractable resistance to electrode insertion was met. There was a persistent foreign body reaction at the site of implantation of saline-treated implanted ears but not in the dexamethasone-treated implanted ears. CONCLUSION: Short-term preoperative delivery of dexamethasone through the round window can protect residual hearing during cochlear implantation, especially during technically difficult surgery.Audiology and Neurotology 02/2008; 13(2):86-96. DOI:10.1159/000111780 · 1.85 Impact Factor
- Journal of International Advanced Otology 02/2015; 10(3):234-239. DOI:10.5152/iao.2014.190 · 0.13 Impact Factor
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ABSTRACT: The authors present for the first time a study of the exposure latitude of deep-ultraviolet conformable contact photolithography in a nonevanescent regime. Exposures of grating patterns with half-pitches ranging from several hundred nanometers to 100 nm are simulated and experimentally demonstrated using an optimized trilayer resist stack. They show that a mask geometry with the absorber embedded in the glass improves image contrast, and therefore exposure latitude over a conventional chrome-on-glass mask geometry. They show that conformable contact photolithography is suitable for printing 500–100 nm half-pitch features with an exposure latitude of ±22% for ±15% linewidth tolerance.Journal of Vacuum Science & Technology B Microelectronics and Nanometer Structures 01/2008; 26(1). DOI:10.1116/1.2817634 · 1.36 Impact Factor