Intratympanic steroid therapy for refractory sudden sensory hearing loss: a 12-year experience with the Silverstein catheter

Abstract

Background: Sudden sensorineural hearing loss (SSNHL) is commonly encountered in clinical practice.

Aim/Objective: Determine if local administration of corticosteroids to the inner ear can improve hearing and speech intelligibility after the failure of conventional treatment for SSNHL loss when administered for 10 days after the onset of the hearing loss in a large cohort of 77 patients.

Materials and methods: A Silverstein MicroWick™ was placed under local anesthesia and endoscopic control in the round window niche, allowing self-administration of methylprednisolone twice daily for four weeks.

Results: An improvement of the pure tone average was shown in 31% of patients. Speech intelligibility improved significantly in 55% of the total cohort and in 34% of the population with a stable pure tone average. Among the 77 patients, 22% used a hearing aid. Only 14% of the patients were hearing-aid users in the group with an improvement in speech intelligibility as opposed to 31% in the failure group.

Conclusion and significance: Local administration of steroids to the inner ear through the round window route improves hearing and speech intelligibility in patients after failure of conventional therapy. The use of a hearing aid was reduced by 50% when speech intelligibility was improved.

Chinese abstract

背景：突然性感觉神经性听力损失（SSNHL）在临床实践中经常遇到。

目的：确定在77名SSNHL患者中, 在听力损失发作后进行常规治疗10天无效后, 对内耳局部注射皮质类固醇是否可改善听力和语言清晰度。

材料和方法：在局部麻醉后通过内窥镜控制, 将Silverstein MicroWick TM置于圆窗龛中, 允许每日两次自我注射甲基强的松龙, 持续四周。

结果：31％的患者表现出纯音平均值的改善。语音清晰度的显著改善发生于整个患者群的55％以及稳定纯音平均值人群的34％。在77名患者中, 22％使用助听器。该组中仅有14％的患者使用助听器, 且语音清晰度得以改善, 而失败组的助听器使用者占31％。

结论和意义：通过圆窗向内耳局部施用类固醇可改善常规治疗失败后的患者的听力和语言清晰度。当语音清晰度得到改善时, 助听器的使用减少了50％。

Keywords:

• Idiopathic sudden sensorineural hearing loss
• steroid therapy
• intratympanic therapy

Disclosure statement

No potential conflict of interest was reported by the authors.