Comparison of intratympanic and intravenous dexamethasone treatment on sudden sensorineural hearing loss with diabetes.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the efficacy of intratympanic administration of dexamethasone (IT-DEX) treatment on sudden sensorineural hearing loss (SSNHL) patients with diabetes by comparing the results with intravenous administration of dexamethasone (IV-DEX) treatment.

STUDY DESIGN:

Comparative study.

SETTING:

University hospital and affiliated hospital.

PATIENTS:

Ten sequential SSNHL patients with diabetes receiving IT-DEX and 21 sequential SSNHL patients with diabetes receiving IV-DEX. Patients with low tone hearing loss were excluded.

INTERVENTION:

In the IT-DEX group, two methods were applied to deliver DEX (4 mg/ml): injection through a perforation made by laser-assisted myringotomy or through a tympanostomy tube. IT-DEX administration was performed on 8 sequential days. In the IV-DEX group, DEX was administrated intravenously starting from an amount of 8 mg/d followed by taped doses for 10 days.

MAIN OUTCOME MEASURES:

Preprocedure and postprocedure hearing levels and complications.

RESULTS:

In the IT-DEX group, the average hearing level before the treatment was 79 dB. Overall, all 10 patients showed improvement of more than 10 dB in the pure-tone audiogram, with a mean improvement of 41 dB. Seven patients (70%) demonstrated successful results, and four recovered completely. In the IV-DEX group, 14 (67%) of the 21 patients showed improvement of more than 10 dB with a mean improvement of 25 dB. Thirteen patients (62%) demonstrated successful results. Free blood sugar during and after the IT-DEX treatment remained below the pretreatment levels, whereas four patients in the IV-DEX group demonstrated worsening of the hyperglycemia.

CONCLUSION:

IT-DEX treatment is at least as effective as IV-DEX treatment for SSNHL patients with diabetes.

• Authors: Seiji Kakehata, Akira Sasaki, Kasumi Oji, Kazunori Futai, Shuji Ota, Kimitoshi Makinae, Hideichi Shinkawa
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 27 Issue 5 Pg. 604-8 (Aug 2006) ISSN: 1531-7129 [Print] United States
• PMID: 16788418 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Glucocorticoids
• Dexamethasone

Topics

• Adult
• Aged
• Aged, 80 and over
• Dexamethasone (administration & dosage, therapeutic use)
• Diabetes Complications (drug therapy)
• Female
• Glucocorticoids (administration & dosage, therapeutic use)
• Hearing Loss, Sensorineural (drug therapy)
• Hearing Loss, Sudden (drug therapy)
• Humans
• Injections, Intravenous
• Laser Therapy
• Male
• Middle Aged
• Middle Ear Ventilation
• Treatment Outcome
• Tympanic Membrane (surgery)