Intratympanic Steroids for Treatment of Sudden Hearing Loss after Failure of Oral Steroids Therapy

Abstract

Objective : To evaluation treatment with intratympanic steroid (dexamethasone) for sudden sensor- ineural hearing loss after failure of oral steroid (prednisolone) treatment.

Materials and Methods : Randomized prospective controlled clinic trail. 100 patients presenting with idiopathic sudden sensorineural hearing loss were treated with prednisolone orally (1 mg./kg/day) for seven days. After this period, patients with treatment failure (36 cases) were randomized offered intratympanic steroid injection. 18 patients received three weekly 0.5 ml. injections of dexamethasone (4 mg/ml.), whereas the other 18 patients were treated orally at least 14 days. Recovery was reported as improvement of hearing more than 15 dB in pure tone average or an increase in Speech Discrimination Score (SDS) of 15% or greater.

Results : Intratympanic steroid treatment adding improved hearing loss in ten patients (55%) compared to standard oral steroid treatment (P <0.05). No serious adverse effects were observed.

Conclusion : Intratympanic steroid are an effective and safe rescue therapy in sudden sensorineural hearing loss cases that are refractory to standard treatment and might be a preferable choice as initial therapy.