Intratympanic steroid injection for sudden sensorineural hearing loss: Impact of injection interval on therapeutic efficacy. Issue 6 (December 2020)

• Record Type: Journal Article
• Authors: Kwak, Min Young; Yang, Chan Ju; Shim, Hyun Joon; Song, Chan Il; Kim, Jong Yang; Lee, Il Woo; Jung, Sung Wook; Lim, Hyun Woo; Kwon, Joong Keun; Lee, Jun Ho; Choi, June; An, Yun Suk; Lee, Kyu-Yup; Chung, Jong Woo
• Is Part Of: Auris nasus larynx. Volume 47:Issue 6(2020)
• Page Start: 982
• Page End: 989
• Publication Date: 2020-12
• Subjects: Sudden hearing loss -- Intratympanic -- Dexamethasone -- Audiometry; Otolaryngology -- Periodicals; Electronic journals; 616
• DOI: 10.1016/j.anl.2020.06.009
• Languages: English
• ISSNs: 0385-8146

Abstract

Abstract: Objective: To compare the effect of injection time intervals of intratympanic (IT) dexamethasone (DEX) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Methods: Seventy-five adults with ISSNHL were grouped into four groups according to the IT DEX interval. In addition to concurrent oral steroid medication for two weeks, patients received IT DEX injections every 1, 2, 3, and four days, respectively. (Group 1, Group 2, Group 3, and Group 4). We evaluated the treatment outcomes according to modified criteria from "Clinical Practice Guideline: Sudden Hearing Loss" of the American Academy of Otolaryngology-Head and Neck Surgery (AAOHNS) to justify treatment success. Results: There were no significant differences in demographic and baseline audiometric data. The mean of pure tone audiometry (PTA) and speech discrimination score (SDSs) were significantly improved after oral steroid and IT DEX treatment in all four groups. Group 1 showed significantly higher improvement than Group 4 in PTA after treatment. There was a significantly higher complete recovery (CR) rate in Group 1 than Group 4. Conclusion: We found a statistically significant difference in the complete hearing recovery rate and audiometric results (PTA) between the group with a daily interval of injections and the group with a four-day time interval. Therefore, daily time intervals in intratympanic steroid injection may be considered as an option for better improvement of hearing in patients with ISSNHL. Highlights: The better hearing improvement of hearing in ISSNHL patients treated with oral steroid and intratympanic steroids within 2 weeks of the onset of symptoms, was expected when they had shorter time interval in each intratympanic steroids injection. Combination therapy including oral steroid with intratympanic steroid was used widely for the initial treatment of ISSNHL in medical center in Korea, and the frequency of intratympanic steroid administration varies among the centers.