A Comparison of The Hearing Level before and after Intratympanic Dexamethasone Injection in Patients with Sudden Sensorineural Hearing Loss after Failure of Oral Prednisolone Therapy
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Abstract
BACKGROUND: Intratympanic steroid injection is an option for the treatment of sudden sensorineural hearing loss (SSNHL) in prednisolone-unresponsive patients. However, there is no strong evidence about the steroid type, number, and frequency of injections.
OBJECTIVES: To compare the average pure tone audiogram at 500 Hz, 1,000 Hz, and 2,000 Hz, and the speech discrimination score before and after one month of intratympanic dexamethasone injection in patients with SSNHL who were unresponsive to prednisolone.
METHODS: A quasi-experimental study was conducted in 40 SSNHL patients at the Outpatient Otolaryngology Department, Chao Phraya Yommarat Hospital, Suphan Buri Province, Thailand during February 2020 to January 2022. A dosage of 0.5-0.7 ml. of intratympanic dexamethasone injection was administered once a week for four times. The data were analyzed by a dependent t-test.
RESULTS: The data from the 40 patients were analyzed at a one-month follow-up after four injections of intratympanic dexamethasone. The mean volume level of the pure sound waves was 8.2 decibels, which was an improvement (from 73.4 to 65.2 decibels; p<0.001), and the mean speech discrimination score improved 9.6% (from 40.5% to 50.1%; p<0.001). For minor complications after the intratympanic dexamethasone injection, pain was reported in one patient (2.5%), and transient dizziness in two patients (5%) without perforation of the tympanic membrane.
CONCLUSIONS: Intratympanic dexamethasone injection in treatment of SSNHL in prednisolone-unresponsive patients therefore improves the level of the hearing and speech discrimination scores.
Thaiclinicaltrials.org number, TCTR20220128003
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