Contribution of intratympanic steroids in the primary treatment of sudden hearing loss*

Abstract

Objective: The primary objective is to investigate the contribution of intratympanic steroids in the primary treatment of idiopathic sudden sensorineural hearing loss (ISSNHL). The secondary objective is to compare methylprednisolone (MP) and dexamethasone in terms of their effectiveness and injection-site pain.

Methods: Two hundred and four patients with ISSNHL, 144 patients underwent systemic steroid therapy (SST) alone and 60 patients underwent combined therapy (CT). The effectiveness of the treatment was assessed according to the Furuhashi criteria. Injection-site pain after the procedure was assessed at 5 and 60 min on a visual analog scale (VAS).

Results: Successful recovery was 55% in the CT group and 34% in the SST alone group (p = .004). Patients whose initial hearing level is severe, the success rate was statistically significantly higher with CT (p = .0001). Hearing improvement differed significantly between the MP and dexamethasone (p = .015). Injection-site pain at 5 min after the procedure, higher VAS scores were obtained with MP (p = .002).

Conclusion: In the primary treatment of sudden hearing loss, in which the level of hearing loss is 70–89 dB HL, the addition of ITS to the treatment significantly increased the success rate. The pain occurring in the middle ear was high but tolerable in the first few minutes by MP.

Chinese abstract

目的：主要目的是研究鼓室内类固醇（ITS）对初步治疗特发性突发性感音神经性听力损失（ISSNHL）的作用。次要目的是就鼓室内注射甲强龙（MP）和地塞米松来比较两者的有效性及注射部位疼痛度。

方法：在224例ISSNHL患者中, 144例患者只接受全身性激素治疗（SST）, 60例接受联合治疗（CT）。根据Furuhashi标准和至少10dB听力增益标准来评估治疗的有效性。根据视觉模拟评分（VAS）, 评估术后5分钟和60分钟时鼓室内注射部位疼痛度。

结果：根据Furuhashi标准, 标志成功恢复的完全恢复和显著恢复在CT组中为55％, 在SST组中为34％；他们的差异有统计学意义（p = 0.004）。根据严重听力损失的初始听力水平, 联合治疗的成功率在统计学上显著更高（p = 0.0001）。 MP和地塞米松之间的听力改善显著不同（p = 0.015）。对于手术后5分钟的注射部位疼痛, 用MP治疗的患者比服用地塞米松的患者获得更高的VAS评分；其差异有统计学意义（p = 0.002）。

结论：在突发性听力损失的初步治疗中, 听力损失水平为70-89 dB HL, 治疗中加入ITS显著提高了成功率。 注射MP 导致中耳的疼痛度高, 但在最初几分钟内是可以忍受的。

Keywords:

• Hearing loss
• sudden
• injection
• intratympanic
• methylprednisolone
• dexamethasone
• visual analog scale

Disclosure statement

The authors have no funding, financial relationships, or conflicts of interest to disclose.