Frequency-specific efficacy of intratympanic steroid on idiopathic sudden sensorineural hearing loss

Abstract

Background: Hearing recovery would be different in each sound frequency in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).

Aims/objectives: To analyze frequency-specific efficacy of intratympanic steroid on ISSNHL.

Materials and methods: Of a total of 381 patients with ISSNHL (hearing threshold ≥40 dB; ≤30 days until treatment), 174 patients (174 ears) received systemic steroid plus hyperbaric oxygen therapy (HBO group), and 207 patients (208 ears) received systemic plus intratympanic steroid (IT group). Hearing thresholds at 125–8000 Hz were measured at every octave before and after treatment.

Results: % of patients with hearing gains ≥10 dB in the IT group was significantly higher for 500 Hz and the average of 5 mid-frequencies, tended to be higher for 1000 Hz, but was significantly lower for 8000 Hz, compared to the HBO group. Multiple regression analysis showed that hearing recovery was negatively correlated with patients’ age for 125/2000/4000/8000 Hz and with days from onset to treatment for all frequencies, and also revealed better hearing recovery at 500/1000 Hz in the IT group than in the HBO group.

Conclusions: Intratympanic steroid is more effective than hyperbaric oxygen to yield better hearing outcomes at mid-frequencies and would be advantageous to restore sound/speech perception.

Significance: Superiority of intratympanic steroid over hyperbaric oxygen for treating ISSNHL was verified.

Chinese abstract

背景：特发性突发性感音神经性聋（ISSNHL）患者的听力恢复在不同的音频是不同的。

目的：分析鼓室内类固醇对ISSNHL的频率特异性疗效。

材料与方法：381例ISSNHL患者（听力阈值!40dB；治疗前30天）中, 174例（174耳）接受全身类固醇加高压氧治疗（HBO组）, 207例（208耳）接受全身类固醇加鼓室内类固醇治疗（IT组）。治疗前后测量每八度125-8000赫兹的听力阈值。

结果：与HBO组相比, IT组的听力增强!10dB的患者百分比在500Hz时显著较高, 5个中频的平均值在1000Hz时趋于较高, 但在8000Hz时显著较低。多元回归分析显示, 在125/2000/4000/8000赫兹时, 听力恢复与患者年龄呈负相关；在所有频率下, 听力恢复与患者从发病到治疗的天数呈负相关；在500/1000赫兹时, IT组的听力恢复优于HBO组。

结论：鼓室内类固醇比高压氧更有效地改善中频听力, 有利于恢复声音/语音感知。

意义：证实了鼓室内类固醇治疗ISSNHL的优越性。

Keywords:

• Idiopathic sudden sensorineural hearing loss
• intratympanic steroid
• hyperbaric oxygen therapy
• frequency-specific efficacy

Disclosure statement

No potential conflict of interest was reported by the author(s).