Intratympanic methylprednisolone administration promotes the recovery of idiopathic sudden sensorineural hearing loss: a retrospective case-control study

Abstract

Background: Efficacy of current treatment methods in idiopathic sudden sensorineural hearing loss (ISSNHL) is still unsatisfactory.

Objective: This study aimed to discover in differences in effect between steroid applications responsible for promoting the prognosis in ISSNHL.

Materials and methods: A study was conducted to diagnose ISSNHL patients in our hospital from January 2014 to September 2016. All patients accepted treatments including intravenous injection (intravenous dexamethasone, [IV DXM]), intratympanic injection (intratympanic methylprednisolone [IT MP], intratympanic dexamethasone [IT DXM]) or combined injections with steroids (IV + IT DXM). Patients were divided into groups according to treatment outcomes and clinical characteristics of each group were compared for univariate comparison. Logistic regression was utilized to verify screening factors from univariate comparison for exclude biases.

Results: There were 313 patients with ISSNHL enrolled in the study. Logistic regression verified that vertigo (p = .023), severity of hearing loss (p=.969), pattern of hearing loss (p = .03), and the treatment method (p < .001) were statistically related to the patients’ prognosis based on the condition all biases had been excluded as possible. IT MP showed a better prognosis of hearing improvement compared to treatment with IT DXM (OR = 0.5), IV DXM (OR =0.226), and IV DXM + IV DXM (OR = 0.320).

Conclusions and significance: IT MP treatment could be utilized as initial treatment in ISSNHL and might promote outcomes.

Chinese abstract

背景：目前治疗特发性突发性感音神经性失聪（ISSNHL）的方法的疗效仍不令人满意。

目的：本研究旨在发现用于提高 ISSNHL预后的类固醇应用之间的效果差异。

材料与方法：2014年1月至2016年9月, 我院开展了一项诊断ISSNHL患者的研究。所有患者均接受了静脉注射（静脉注射地塞米松, [IV DXM]）、鼓室内注射（鼓室内注射甲基强的松龙[IT MP], 鼓室内注射地塞米松[IT DXM]）或联合注射类固醇（IV + IT DXM）等治疗。根据治疗结果将患者分组, 并比较各组的临床特征来进行单变量比较。为了排除偏差, 运用逻辑回归来验证由单变量比较得出的筛选因子。

结果：共有313名ISSNHL患者参加了该研究。 逻辑回归分析证实眩晕（p = .023）、听力损失严重程度（p = .969）、听力损失模式（p = .03）和治疗方法（p <.001）都与患者的预后有统计学相关性, 患者预后是在尽可能排除所有偏倚的条件下得出的。与使用IT DXM（OR = 0.5）、IV DXM（OR = 0.226）和IV DXM + IV DXM（OR = 0.320）的治疗相比, IT MP显示更好的听力改善预后。

Keywords:

• Idiopathic sudden sensorineural hearing loss
• intratympanic injection
• methylprednisolone

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by National Natural Science Foundation of China, [Grant No.81600799].