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Intratympanic steroid injection as a salvage treatment for sudden sensorineural hearing loss

Published online by Cambridge University Press:  17 November 2014

S Belhassen  and
I Saliba
S Belhassen
Affiliation:
Division of Otolaryngology—Head and Neck Surgery, University of Montreal, Quebec, Canada
I Saliba*
Affiliation:
Montreal University Hospital Centre (CHUM), Quebec, Canada
*
Address for correspondence: Prof I Saliba, Otolaryngology Department, Centre Hospitalier de l'Université de Montréal – Notre-Dame Hospital, 1560 Sherbrooke East Montreal, Quebec, Canada H2L 4 M1 Fax: +1 514 737–4822 E-mail: [email protected]
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Abstract

Objective:

To determine the efficacy of intratympanic methylprednisolone injections for treating sudden sensorineural hearing loss.

Method:

A retrospective chart review was performed to identify patients suffering from sudden sensorineural hearing loss with no recovery after oral steroids. Patients were given up to three intratympanic methylprednisolone injections at one-week intervals. They were classified according to their functional hearing class, remission was monitored and potential factors affecting prognosis were analysed.

Results:

Intratympanic injections provide effective salvage therapy for sudden sensorineural hearing loss (p = 0.039). Changes in pure tone average and speech discrimination score were analysed following intratympanic methylprednisolone injections. The pure tone average reached a plateau after the second injection; however, the speech discrimination score improved until after the third injection. Hearing improvement after intratympanic injections mainly occurred at low frequencies. The interval between symptoms appearing and intratympanic injections starting was not significantly associated with remission (p = 0.680).

Conclusion:

A delay between symptom onset and the first intratympanic methylprednisolone injection does not seem to affect prognosis.

Keywords

Hearing Loss, SuddenSteroidsSalvage TherapyMethylprednisolone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 12 , December 2014 , pp. 1044 - 1049
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Plaza, G, Herráiz, C. Intratympanic steroids for treatment of sudden hearing loss after failure of intravenous therapy. Otolaryngol Head Neck Surg 2007;137: 74–8Google Scholar
2Banerjee, A, Parnes, LS. Intratympanic corticosteroids for sudden idiopathic sensorineural hearing loss. Otol Neurotol 2005;26:878–81Google Scholar
3Rauch, SD. Intratympanic steroids for sensorineural hearing loss. Otolaryngol Clin North Am 2004;37:1061–74Google Scholar
4Mattox, DE, Simmons, FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463–80CrossRefGoogle ScholarPubMed
5Lefebvre, PP, Staecker, H. Steroid perfusion of the inner ear for sudden sensorineural hearing loss after failure of conventional therapy: a pilot study. Acta Otolaryngol 2002;122:698–702Google Scholar
6Byl, FM Jr.Sudden hearing loss: eight years' experience and suggested prognostic table. Laryngoscope 1984;94:647–61CrossRefGoogle ScholarPubMed
7Slattery, WH, Fisher, LM, Iqbal, Z, Friedman, RA, Liu, N. Intratympanic steroid injection for treatment of idiopathic sudden hearing loss. Otolaryngol Head Neck Surg 2005;133:251–9CrossRefGoogle ScholarPubMed
8Filipo, R, Covelli, E, Balsamo, G, Attanasio, G. Intratympanic prednisolone therapy for sudden sensorineural hearing loss: A new protocol. Acta Otolaryngol 2010;130:1209–13Google Scholar
9Wilson, WR, Byl, FM, Laird, N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol 1980;106:772–6CrossRefGoogle ScholarPubMed
10Parnes, LS, Sun, AH, Freeman, DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope 1999;109:1–17Google Scholar
11Alles, MJ, der Gaag, MA, Stokroos, RJ. Intratympanic steroid therapy for inner ear diseases, a review of the literature. Eur Arch Otorhinolaryngol 2006;263:791–7CrossRefGoogle ScholarPubMed
12Chandrasekhar, SS. Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otol Neurotol 2001;22:18–23CrossRefGoogle ScholarPubMed
13Dallan, I, De Vito, A, Fattori, B, Casani, AP, Panicucci, E, Berrettini, S et al. Intratympanic methylprednisolone in refractory sudden hearing loss: a 27-patient case series with univariate and multivariate analysis. Otol Neurotol 2010;31:25–30Google Scholar
14Kiliç, R, Safak, MA, Oğuz, H, Kargin, S, Demirci, M, Samim, E et al. Intratympanic methylprednisolone for sudden sensorineural hearing loss. Otol Neurotol 2007;28:312–6Google Scholar
15Li, P, Zeng, XL, Ye, J, Yang, QT, Zhang, GH, Li, Y. Intratympanic methylprednisolone improves hearing function in refractory sudden sensorineural hearing loss: a control study. Audiol Neurootol 2011;16:198–202CrossRefGoogle ScholarPubMed
16Xenellis, J, Papadimitriou, N, Nikolopoulos, T, Maragoudakis, P, Segas, J , Tzagaroulakis, A et al. Intratympanic steroid treatment in idiopathic sudden sensorineural hearing loss: a control study. Otolaryngol Head Neck Surg 2006;134:940–5CrossRefGoogle ScholarPubMed
17Committee on hearing and equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. American Academy of Otolaryngology – Head and Neck Surgery Foundation. Otolaryngol Head Neck Surg 1995;113:186–7Google Scholar
18Tsai, YJ, Liang, JG, Wu, WB, Ding, YF, Chiang, RP, Wu, SM. Intratympanic injection with dexamethasone for sudden sensorineural hearing loss. J Laryngol Otol 2011;125:133–7CrossRefGoogle ScholarPubMed
19Lee, JD, Park, MK, Lee, CK, Park, KH, Lee, BD. Intratympanic steroids in severe to profound sudden sensorineural hearing loss as salvage treatment. Clin Exp Otorhinolaryngol 2010;3:122–5CrossRefGoogle ScholarPubMed
20Seggas, I, Koltsidopoulos, P, Bibas, A, Tzonou, A, Sismanis, A. Intratympanic steroid therapy for sudden hearing loss: a review of the literature. Otol Neurotol 2011;32:29–3Google Scholar
21Shaia F, T, Sheehy J, L. Sudden sensori-neural hearing impairment: a report of 1,220 cases. Laryngoscope 1976;86:389–98Google Scholar
22Lee, JD, Lee, BD, Hwang, SC. Vestibular schwannoma in patients with sudden sensorineural hearing loss. Skull Base 2011;21:75–8CrossRefGoogle ScholarPubMed
23Rauch, SD, Halpin, CF, Antonelli, PJ, Babu, S, Carey, JP, Gantz, BJ et al. Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: a randomized trial. JAMA 2011;305:2071–9CrossRefGoogle ScholarPubMed
24Nosrati-Zarenoe, R, Hultcrantz, E. Corticosteroid treatment of idiopathic sudden sensorineural hearing loss: randomized triple-blind placebo-controlled trial. Otol Neurotol 2012;33:523–31Google Scholar