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.
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ABSTRACT: IntroductionIntratympanic drug delivery for labyrinth diseases is a non-aggressive outpatient procedure where drugs reach high concentrations in the cochlea and minimum systemic diffusion. The aim of this review is to update the delivery techniques and report on the results obtained with different substances in cochleovestibular disorders. New perspectives in drug development and gene therapy are discussed.Acta Otorrinolaringológica Española 05/2010; 61(3).
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ABSTRACT: The prognostic significance of vertigo in patients with idiopathic sudden sensorineural hearing loss (SSNHL) remains a matter of debate. This paper aims to verify the difference between a group with vertigo and a group without vertigo, and to analyze vertigo's validation as a prognostic factor in patients with SSNHL. This study involved 183 patients with SSNHL. A t-test was used to compare group A (SSNHL with vertigo, n = 31) and group B (SSNHL without vertigo, n = 152). Also we want to verify the interaction effects between vertigo and other prognostic factors using multiple regression analysis. There was a significant difference between group A and group B: the initial hearing level of group A was lower than group B, and their treatment onset was also shorter. In addition, vertigo itself didn't affect hearing improvement, but the interaction variable between vertigo and initial hearing level did affect hearing improvement significantly. The clinical characteristics of patients with vertigo did not directly affect hearing improvement with SSNHL; however, vertigo had an influence on SSNHL though its interaction with the initial hearing levels.Brazilian journal of otorhinolaryngology 08/2013; 79(4):466-470. · 0.55 Impact Factor