Effectiveness of salvage intratympanic dexamethasone treatment for refractory sudden sensorineural hearing loss classified by audiogram patterns

Abstract

Background

Intratympanic dexamethasone is commonly conducted to treat refractory sudden sensorineural hearing loss (RSSNHL). However, no consensus has been reached on its effectiveness.

Objectives

The study aimed to evaluate the effectiveness of otoendoscope-assisted salvage intratympanic dexamethasone treatment (IDT) on RSSNHL with different audiogram patterns after failure of initial therapy.

Material and methods

A total of 108 patients with unilateral RSSNHL were classified into 4 groups according to audiogram patterns. Hearing results were evaluated by pure-tone audiometry (PTA), which was performed at baseline and one month after otoendoscope-assisted salvage IDT. The effectiveness of otoendoscope-assisted salvage IDT was assessed in each group.

Results

The efficiency in low-frequency, high-frequency, flat, and deaf group was 48%, 24.1%, 46.2%, 17.9%, respectively. The efficacy did not differ between the high-frequency and deaf group. Notably, the efficacy in the low-frequency and flat group was significantly higher than that in the deaf group.

Conclusions

Otoendoscope-assisted salvage IDT is a safe and effective treatment for RSSNHL. This treatment provided better results for patients with low-frequency damaged and flat curve audiogram than patients with other audiogram patterns.

Significance

Audiogram patterns should be considered in the clinical management of patients with RSSHNL prior to salvage IDT.

Chinese abstract

背景：鼓室内地塞米松通常用于治疗难治性突发性感音神经性听力损失（RSSNHL）。但是, 其有效性尚未达成共识。

目的：本研究旨在评估初始治疗失败后, 耳内镜抢救性鼓膜内地塞米松（IDT）对具不同听力图模式的RSSNHL的有效性。

材料和方法：将108例单侧RSSNHL患者根据听力图模式分为4组。通过纯音测听（PTA）进行听力结果评估, 这是在基线和耳内镜抢救性鼓膜内地塞米松后一个月进行的。在每组中评估耳内镜抢救性鼓膜内IDT的有效性。

结果：低频、高频、平坦和聋人组的效率分别为48％、24.1％、46.2％和17.9％。高频组和聋人组的疗效没有差异。显然, 低频和平坦组的疗效大大高于聋人组。

结论：耳内镜抢救性鼓膜内IDT是治疗RSSNHL的安全有效的方法。这种治疗为低频受损和平坦曲线听力图的患者提供比其他听力图模式的患者更好的结果。

意义：RSSHNL患者的临床治疗在耳内镜抢救性鼓膜内IDT之前应考虑听力图模式。

Keywords:

• Pure-tone audiometry
• hearing improvement
• round window niche

Disclosure statement

The authors report no conflict of interest.

Author contributions

Jihao Ren conceived and designed research; Duanlong Zhao, Wei Liu and Hongiao Ren collected data and conducted research; Xiaozhu Chen performed statistical analysis; Bing Hu and Mo Chen wrote the initial paper; Zheng Qingyin and Guohui Nie revised the paper; Jihao Ren had primary responsibility for the final content. All authors read and approved the final manuscript.

Additional information

Funding

This work was supported by National Natural Science Foundation of China [81970875, 81700908], Error! Hyperlink reference not valid. [2019A1515011495].