Intratympanic steroids as a salvage therapy for severe to profound idiopathic sudden sensorineural hearing loss

Abstract

Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is defined as a decline in hearing affecting three or more frequencies by 30 dB

Objective: The aim of this study was to evaluate the results of intratympanic steroids as a salvage treatment for severe ISSNHL.

Materials and methods: A regimen of three IT steroid injections was offered to patients who failed a 7-days intravenous steroid treatment. Eighty-four patients underwent IT salvage treatment (IT group). Their outcomes were compared with those of 255 patients with severe ISSNHL who received the same intravenous steroid regimen without salvage IT steroid therapy (Control group).

Results: 56% of the patients in the IT group had a hearing improvement of >15 dB after one month. The average hearing improvements were 26.5 ± 28 dB and 27.9 ± 24 dB in the IT group and the Control group, respectively (p = .67). However, patients with a type E audiogram pattern (total deafness), displayed a substantial hearing gain.

Conclusion: Intratympanic steroids failed to show a global auditory benefit as a salvage treatment in patients with severe ISSNHL.

Significance: Our data suggest that a salvage treatment with intratympanic dexamethasone may be offered to patients with total deafness for whom the first systemic treatment has failed.

Chinese abstract

背景：特发性突发性感音神经性听力损失（ISSNHL）定义为三个或更多频率的听力下降30 dB。

目的：本研究的目的是评估重度ISSNHL的鼓室内类固醇挽救性治疗的结果。

材料和方法：为7天静脉注射类固醇治疗无效的患者提供三种IT类固醇注射方案。 84名患者接受了IT抢救治疗（IT组）。将他们的结果与255名重度ISSNHL患者的结果进行比较, 这些患者接受相同的静脉注射类固醇治疗但没有接受挽救性IT类固醇治疗（对照组）。

结果：IT组中56％的患者在一个月后听力改善了 15 dB以上。 IT组和对照组的平均听力改善分别为26.5±28 dB和27.9±24 dB（p = .67）。然而, 具有E型听力图模式（全耳聋）的患者表现出显著的听力增益。

结论：作为重度ISSNHL患者的一种挽救性治疗, 鼓室内类固醇激素未能显示对整体听觉的增益。

意义：我们的数据表明, 对于首次系统性治疗失败的全耳聋患者, 可以进行鼓室内地塞米松挽救性治疗。

Keywords:

• Intratympanic corticosteroids
• dexamethasone
• audiogram
• intravenous steroid

Disclosure statement

No potential conflict of interest was reported by the authors.