Transtympanic steroid for treatment of sudden hearing loss

ArticleinOtolaryngology Head and Neck Surgery 125(3):142-6 · October 2001with16 Reads
DOI: 10.1067/mhn.2001.117162 · Source: PubMed
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.
    • "However, we could not establish significantly differences between the rescue group and first line group of patients due to the low number of cases in the first line group. Efficacy of treatment was also categorized according to Siegel's criteria [40,41] relative gain [42] and the Speech Reception Thresholds (SRT) Speech Discrimination Testing (SDS) and the maximum speech intelligibility [2,22,434445. Many authors agree that patients that started therapy soon after failures of systemic therapy was detected had an evident advantage [46,47]. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: To evaluate the effectiveness and safety of intratympanic Methylprednisolone injection in patients with Sudden Sensorineural Hearing loss (SSNHL) by means of a comparison between subjective and objective outcomes and a review of the literature regarding Methylprednisolone transtympanic administration.
    Full-text · Article · Nov 2015 · Journal of International Advanced Otology
    • "Author 1 alternating days injection [total 3] Igor Texeira [48] 1 weekly injection [ total 3] Fitzgerald [44] Guillermo Plaza [47] Benjamin J Wycherly [50] 1 weekly injection [ total 4] Our study 2 weekly injections until improvement Avik Banerjee [22] Not specified France Van Wijck [45] Sébastian Barriat [43] Perfusion 4 weeks Stefan Plontke [37] Perfusion for 10 days Wandong She [49] Perfusion for 14 days Richard D Kopke [32] Separated injection in 10-14 days [total 4] Gerard J Gianoli [2] William H Slattery [8] Many authors agree that patients that started therapy soon after failures of systemic therapy was detected had an evident advantage [46,47]. In the present study time elapsed from onset of the symptoms to the beginning of the ITS injections was 11.3 days. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: To evaluate the effectiveness and safety of intratympanic Methylprednisolone injection in patients with Sudden Sensorineural Hearing loss (SSNHL) by means of a comparison between subjective and objective outcomes and a review of the literature regarding Methylprednisolone transtympanic administration.
    Full-text · Article · Sep 2015 · Journal of International Advanced Otology
    • "Also, ITS treatment may have a longer therapeutic window (6 weeks for IT and 10-14 days for oral steroids). Since it may decrease the excretion of systemic inflammatory mediators, its effect is thought to be increased in combined treatment789 . The aim of this study is to report our experience on the effects of ITS administration, concurrent with SS treatment, in the management of ISSHL. "
    [Show abstract] [Hide abstract] ABSTRACT: OBJECTIVE: The treatment of idiopathic sudden sensorineural hearing loss (ISSHL) depends mainly on the steroids, and there is an increasing number of studies about not only systemic usage but also local administration of steroids to the target organ. The aim of this study is to determine the effects of intratympanic steroid (ITS) administration as adjuvant to systemic steroid (SS) treatment in the management of ISSHL. MATERIALS and METHODS: Seventy-nine patients (41 F, 38 M) with a mean age of 48.2 years were included in the study. The data were collected by retrospective analysis of the patient records. The hearing levels of 36 patients treated with only SS (group I) and 43 patients treated with SS and ITS concomitantly (group II) were evaluated with pure tone audiometry tests at 500, 1000, 2000, 4000, and 8000 Hz frequencies in the pretreatment period and 1 and 3 months after treatment. RESULTS: The mean values of hearing thresholds in the audiometry performed in the pretreatment period and 1 and 3 months after treatment in the SS treatment group were 52.2 +/- 20, 39.5 +/- 25.3, and 35.3 +/- 25.3, respectively, while in the IT+SS treatment group, these values were determined as 60.7 +/- 19.9, 38.3 +/- 23.8, and 33.2 +/- 22.7, respectively. The improvements in mean hearing thresholds by time were statistically significantly different between the 2 groups (p<0.05). CONCLUSION: Among patients with ISSHL, it has been determined that initial SS treatment with concomitant ITS administration may improve the hearing gain. This improvement was more notable in patients with non-profound hearing loss.
    Article · Feb 2015
Show more