Intratympanic steroid perfusion for refractory sudden sensorineural hearing loss.

Abstract

OBJECTIVE:

Patients with sudden sensorineural hearing loss (SSHL) can benefit from systemic steroid therapy. Unfortunately, some patients are not candidates for steroid therapy due to concern over possible complications. Furthermore, not all patients will benefit from steroid administration. This study evaluates the potential benefits and safety of treating patients with SSHL refractory to oral steroids with intratympanic steroid therapy.

METHODS:

A retrospective case review was performed on all patients who presented with sudden sensorineural hearing loss refractory to oral steroid therapy during the past year. Seventeen patients were identified. All patients underwent intratympanic steroid administration, via MicroWick placement and/or round window catheter placement.

RESULTS:

Nine patients with sudden sensorineural hearing loss showed an improvement with intratympanic steroid therapy, consisting of MicroWick placement with dexamethasone drop (Decadron) administration for 1-2 weeks and/or round window catheter placement with steroid perfusion. Only one of the patients presenting with hearing loss present for greater than 8 weeks benefited from intratympanic therapy. Complications were few and included tympanic membrane perforation, chronic otitis media, dysequilibrium, and dysguesia.

CONCLUSIONS:

Intratympanic steroid therapy can be beneficial in treating patients with sudden sensorineural hearing loss refractory to oral steroid use.

EBM RATING:

C.

• Authors: Brian D Herr, Sam J Marzo
• Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 132 Issue 4 Pg. 527-31 (Apr 2005) ISSN: 0194-5998 [Print] England
• PMID: 15806039 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Methylprednisolone Hemisuccinate
• Dexamethasone

Topics

• Administration, Oral
• Administration, Topical
• Adult
• Aged
• Anti-Inflammatory Agents (administration & dosage, adverse effects)
• Audiometry, Pure-Tone
• Auditory Threshold (drug effects)
• Dexamethasone (administration & dosage, adverse effects)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Hearing Loss, Sudden (diagnosis, drug therapy)
• Humans
• Male
• Methylprednisolone Hemisuccinate (administration & dosage, adverse effects)
• Middle Aged
• Middle Ear Ventilation
• Perfusion
• Retrospective Studies
• Round Window, Ear (drug effects)
• Treatment Outcome