Skip to main content
Log in

Effectiveness of intratympanic dexamethasone for refractory sudden sensorineural hearing loss

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The purpose of this study was to investigate the effectiveness of intratympanic steroids in patients with idiopathic sudden sensorineural hearing loss who did not respond to initial systemic steroid therapy. This retrospective study involved 51 patients, who did not respond to systemic steroids as a first-line treatment. Initial systemic steroid therapy consisted of administration of methylprednisolon intravenously (250 mg) at the first day and followed by orally (1 mg/kg) tapering for 14 days. Twenty-one patients accepted intratympanic treatment, and the remaining 30 patients who refused intratympanic treatment were evaluated as the control group. Steroids (dexamethasone drops, 1 mg/mL) were administered through a ventilation tube. Hearing was assessed immediately before treatment and 2 months after treatment. Recovery of hearing was defined as an improvement of >20 dB in the pure tone average. We tested 250, 500, 1,000, 2,000, 4,000, and 8,000 Hz frequencies for the pure tone audiometric evaluation. Statistically Student’s t test, Mann–Whitney U test, Chi-squared and Fisher’s exact tests were used. The pure tone average improved in 47.6 % of the intratympanic group and in 10 % of the control group (p = 0.002), with pure tone average improvements of 19.9 ± 16.5 and 4.76 ± 9.6 dB in the intratympanic and control groups, respectively. When the hearing threshold at each frequency was analyzed, improvements at all frequencies were significantly greater in the intratympanic steroid group when compared with the control group (p < 0.01). Intratympanic steroid administration is an effective therapy for sudden sensorineural hearing loss in patients, who are refractory to primary systemic steroid therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Filipo R, Covelli E, Balsamo G, Attanasio G (2010) Intratympanic prednisolone therapy for sudden sensorineural hearing loss: a new protocol. Acta Otolaryngol 130(11):1209–1213

    Article  CAS  PubMed  Google Scholar 

  2. Lautermann J, Sudhoff H, Junker R (2005) Transtympanic corticoid therapy for acute profound hearing loss. Eur Arch Otorhinolaryngol 262(7):587–591

    Article  PubMed  Google Scholar 

  3. Hughes GB, Freedman MA, Haberkamp TJ, Guay ME (1996) Sudden sensorineural hearing loss. Otolaryngol Clin North Am.Rev 29(3):393–405

    CAS  Google Scholar 

  4. Wilson WR, Byl FM, Laird LN (1980) The efficiency of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol 106(12):772–776

    Article  CAS  PubMed  Google Scholar 

  5. Moskowitz D, Lee KJ, Smith HW (1984) Steroid use in idiopathic sudden sensorineural hearing loss. Laryngoscope 94(5 Pt 1):664–666

    CAS  PubMed  Google Scholar 

  6. Kakehata S, Sasaki A, Oji K et al (2006) Comparison of intratympanic and intravenous dexamethasone treatment on sudden sensorineural hearing loss with diabetes. Otol Neurotol 27(5):604–608

    Article  PubMed  Google Scholar 

  7. Parnes LS, Sun AH, Freeman DJ (1999) Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope 109(7 Pt 2):1–17

    Article  CAS  PubMed  Google Scholar 

  8. Chandrasekhar SS (2001) Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otol Neurotol 22(1):18–23

    Article  CAS  PubMed  Google Scholar 

  9. Schuknecht HF, Kamura RS, Nougal PM (1973) The pathology of sudden deafness. Acta Otolaryngol 76(2):75–97

    Article  CAS  PubMed  Google Scholar 

  10. Xenellis J, Papadimitriou N, Nikolopoulos T et al (2006) Intratympanic steroid treatment in idiopathic sudden sensorineural hearing loss: a control study. Otolaryngol Head Neck Surg 134(6):940–945

    Article  PubMed  Google Scholar 

  11. Ho GM, Lin HC, Shu MT, Yang CC, Tsai HT (2004) Effectiveness of intratympanic dexamethasone injection in sudden deafness patients as salvage treatment. Laryngoscope 114(7):1184–1189

    Article  CAS  PubMed  Google Scholar 

  12. Choung YH, Park K, Shin YR, Cho MJ (2006) Intratympanic dexamethasone injection for refractory sudden sensorineural hearing loss. Laryngoscope 116(5):747–752

    Article  CAS  PubMed  Google Scholar 

  13. Battista RA (2005) Intratympanic dexamethasone for profound idiopathic sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 132(6):902–905

    Article  PubMed  Google Scholar 

  14. Lefebvre PP, Staecker H (2002) Steroid perfusion of the inner ear for sudden sensorineural hearing loss after failure of conventional therapy: a pilot study. Acta Otolaryngol 122(7):698–702

    Article  CAS  PubMed  Google Scholar 

  15. Plaza G, Herráiz C (2007) Intratympanic steroids for treatment of sudden hearing loss after failure of intravenous therapy. Otolaryngol Head Neck Surg 137(1):74–78

    Article  PubMed  Google Scholar 

  16. She W, Dai Y, Du X et al (2010) Hearing evaluation of intratympanic methylprednisolone perfusion for refractory sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 142(2):266–271

    Article  PubMed  Google Scholar 

  17. Salt AN, Ma Y (2001) Quantification of solute entry into cochlear perilymph through the round window membrane. Hear Res 154(1–2):88–97

    Article  CAS  PubMed  Google Scholar 

  18. Saijo S, Kimura RS (1984) Distribution of HRP in the inner ear after injection into the middle ear cavity. Acta Otolaryngol 97(5–6):593–610

    Article  CAS  PubMed  Google Scholar 

  19. Gouveris H, Selivanova O, Mann W (2005) Intratympanic dexamethasone with hyaluronic acid in the treatment of idiopathic sudden sensorineural hearing loss after failure of intravenous steroid and vasoactive therapy. Eur Arch Otorhinolaryngol 262(2):131–134

    Article  PubMed  Google Scholar 

  20. Bamberger CM, Bamberger AM, de Castro M, Chrousos GP (1995) Glucocorticoid receptor beta, a potential endogenous inhibitor of glucocorticoid action in humans. J Clin Invest 95(6):2435–2441

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Sha SH, Taylor R, Forge A, Schacht J (2001) Differential vulnerability of basal and apical hair cells is based on intrinsic susceptibility to free radicals. Hear Res 155(1–2):1–8

    Article  CAS  PubMed  Google Scholar 

  22. Billett TE, Thorne PR, Gavin JB (1989) The nature and progression of injury in the organ of Corti during ischemia. Hear Res 41(2–3):189–197

    Article  CAS  PubMed  Google Scholar 

  23. Kopke RD, Hoffer ME, Wester D, O’Leary MJ, Jackson RL (2001) Targeted topical steroid therapy in sudden sensorineural hearing loss. Otol Neurotol 22(4):475–479

    Article  CAS  PubMed  Google Scholar 

  24. Silverstein H (1999) Use of a new device, the microwick, to deliver medication to the inner ear. Ear Nose Throat J 78(8):595–598

    CAS  PubMed  Google Scholar 

  25. Haynes DS, O’Malley M, Cohen S, Watford K, Labadie RF (2007) Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy. Laryngoscope 117(1):3–15

    Article  CAS  PubMed  Google Scholar 

  26. Plontke SK, Löwenheim H, Mertens J et al (2009) Randomized, double blind, placebo controlled trial on the safety and efficacy of continuous intratympanic dexamethasone delivered via a round window catheter for severe to profound sudden idiopathic sensorineural hearing loss after failure of systemic therapy. Laryngoscope 119(2):359–369

    Article  CAS  PubMed  Google Scholar 

  27. Silverstein H, Choo D, Rosenberg SI, Kuhn J, Seidman M, Stein I (1996) Intratympanic steroid treatment of inner ear disease and tinnitus (preliminary report). Ear Nose Throat J 75(8):468–471

    Google Scholar 

  28. Bird PA, Begg EJ, Zhang M, Keast AT, Murray DP, Balkany TJ (2007) Intratympanic versus intravenous delivery of methylprednisolone to cochlear perilymph. Otol Neurotol 28(8):1124–1130

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Omer Erdur.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Erdur, O., Kayhan, F.T. & Cirik, A.A. Effectiveness of intratympanic dexamethasone for refractory sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 271, 1431–1436 (2014). https://doi.org/10.1007/s00405-013-2594-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-013-2594-x

Keywords

Navigation