Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-06-25T00:57:53.633Z Has data issue: false hasContentIssue false
  • English
  • Français

Intratympanic methylprednisolone as first-line therapy in sudden sensorineural hearing loss: preliminary results from a case–control series

Published online by Cambridge University Press:  02 August 2011

I Dallan ,
S Fortunato ,
A P Casani ,
E Panicucci ,
S Berrettini ,
R Lenzi  and
A Nacci
I Dallan
Affiliation:
ENT Unit, Azienda Ospedaliero Universitaria Pisana, Italy
S Fortunato*
Affiliation:
ENT Unit, Azienda Ospedaliero Universitaria Pisana, Italy
A P Casani
Affiliation:
ENT Unit, Azienda Ospedaliero Universitaria Pisana, Italy
E Panicucci
Affiliation:
Department of Experimental Pathology, University of Pisa, Italy
S Berrettini
Affiliation:
ENT Unit, Azienda Ospedaliero Universitaria Pisana, Italy
R Lenzi
Affiliation:
ENT Unit, Azienda Ospedaliero Universitaria Pisana, Italy
A Nacci
Affiliation:
ENT Unit, Azienda Ospedaliero Universitaria Pisana, Italy
*
Address for correspondence: Dr Susanna Fortunato, ENT Unit, Azienda Ospedaliero Universitaria Pisana, Via Paradisa 3, 56126 Pisa, Italy Fax: +39 050 997517 E-mail: susanna.fortunato@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Sudden sensorineural hearing loss is a true audiological emergency, and its management is much discussed. Currently, no single therapy has been proven effective according to evidence criteria. Recently, intratympanic application of steroids has been increasingly used in refractory cases; however, it has only rarely been reported as first-line therapy.

Materials and methods:

Twenty consecutive patients with sudden sensorineural hearing loss treated between July 2008 and January 2010 were enrolled in this prospective, case–control study. Ten patients were treated with intratympanic steroids and 10 with systemic ‘shotgun’ therapy (including steroids, pentoxifylline, low molecular weight heparin and vitamin E). The two groups were homogeneous in all respects. Pure tone averages were assessed before and after treatment for both groups.

Results:

There were no statistically significant differences between the two groups.

Conclusion:

Intratympanic steroids seem to offer a valid alternative to systemic therapy, with few risks, in sudden sensorineural hearing loss patients, and we recommend their use as first-line therapy.

Keywords

Intratympanic SteroidSudden Hearing LossSudden Deafness TherapySteroids Therapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 10 , October 2011 , pp. 1004 - 1008
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Hughes, GB, Freedman, MA, Haberkamp, TJ, Guay, ME. Sudden sensorineural hearing loss. Otolaryngol Clin North Am 1996;29:393–405CrossRefGoogle ScholarPubMed
2Stokroos, RJ, Albers, FW. The etiology of idiopathic sudden sensorineural hearing loss. A review of the literature. Acta Otorhinolaryngol Belg 1996;50:69–76Google ScholarPubMed
3Schreiber, BE, Agrup, C, Haskard, DO, Luxom, LM. Sudden sensorineural hearing loss. Lancet 2010;375:1203–11CrossRefGoogle ScholarPubMed
4Mattox, DE, Simmons, FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463–80CrossRefGoogle ScholarPubMed
5Fetterman, BL, Sauders, JE, Luxford, WN. Prognosis and treatment of sudden sensorineural hearing loss. Am J Otol 1996;17:529–36Google ScholarPubMed
6Rauch, SD. Idiopathic sudden sensorineural hearing loss. N Engl J Med 2008;359:833–40CrossRefGoogle ScholarPubMed
7Conlin, AE, Parnes, LS. Treatment of sudden sensorineural hearing loss. A meta-analysis. Arch Otolaryngol Head Neck Surg 2007;133:582–6CrossRefGoogle ScholarPubMed
8Garcia-Berrocal, JR, Ramirez-Camacho, R, Lobo, D, Trinidad, A, Verdaguer, JM. Adverse effects of glucocorticoid therapy for inner ear disorders. ORL J Otorhinolaryngol Relat Spec 2008;70:271–4CrossRefGoogle ScholarPubMed
9Hong, SM, Park, CH, Lee, JH. Hearing outcomes of daily intratympanic dexamethasone alone as a primary treatment modality for ISSHL. Otolaryngol Head Neck Surg 2009;141:579–83CrossRefGoogle ScholarPubMed
10Kara, E, Cetik, F, Tarkan, O, Surmelioglu, O. Modified intratympanic treatment for idiopathic sudden sensorineural hearing loss. Eur Arch Otolaryngol 2010;267:701–7CrossRefGoogle ScholarPubMed
11Dallan, 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;31:25–30CrossRefGoogle ScholarPubMed
12Wilson, 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
13Wei, BPC, Muribu, S, O'Leary, S. Steroids for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 2006;(1):CD003998CrossRefGoogle ScholarPubMed
14Sudden deafness. In: http://www.nidcd.nih.gov/health/hearing/sudden.asp [5 April 2010]Google Scholar
15O'Malley, M, Haynes, DS. Sudden hearing loss. Otolaryngol Clin North Am 2008;41:633–49CrossRefGoogle ScholarPubMed
16Gianoli, GJ, Li, JC. Transtympanic steroids for treatment of sudden hearing loss. Otolaryngol Head Neck Surg 2001;125:142–6CrossRefGoogle ScholarPubMed
17Gloddek, B, Lamm, K, Arnold, W. Pharmacological influence on inner ear endothelial cells in relation to the pathogenesis of sensorineural hearing loss. Adv Otorhinolaryngol 2002;59:75–83Google Scholar