Sudden sensorineural hearing loss in diabetes mellitus patients receiving intra-tympanic steroid injections

Shih-Lung Chen; Chia-Ying Ho; Shy-Chyi Chin; Kai-Chieh Chan; Yu-Chien Wang

doi:10.1016/j.amjoto.2024.104576

Sudden sensorineural hearing loss in diabetes mellitus patients receiving intra-tympanic steroid injections

Am J Otolaryngol. 2024 Dec 19;46(1):104576. doi: 10.1016/j.amjoto.2024.104576. Online ahead of print.

Authors

Shih-Lung Chen¹, Chia-Ying Ho², Shy-Chyi Chin³, Kai-Chieh Chan⁴, Yu-Chien Wang⁵

Affiliations

¹ Department of Otorhinolaryngology & Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Biomedical Engineering, College of Engineering, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: [email protected].
² School of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
³ School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁴ Department of Otorhinolaryngology & Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁵ Department of Otorhinolaryngology & Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Otorhinolaryngology & Head and Neck Surgery, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan.

PMID: 39729794
DOI: 10.1016/j.amjoto.2024.104576

Abstract

Background: Sudden sensorineural hearing loss is an acute hearing disorder typically managed using steroids. However, prognostic factors of diabetes mellitus (DM) patients undergoing intra-tympanic steroid injections (ITSIs) are unclear. We explored the prognostic factors for ITSI in DM patients with unilateral SSNHL.

Methods: This retrospective study enrolled 89 DM patients with unilateral SSNHL from July 2016 to June 2022. All patients received ITSIs, and their clinical and audiological data were analyzed.

Results: The patients' mean age was 49.31 ± 16.26 years. After ITSI, the mean hearing level gain was 14.91 ± 20.28 dB, the mean speech reception threshold (SRT) gain was 15.78 ± 32.16 dB, and the mean speech discrimination score (SDS) gain was 16.94 ± 35.06 %. Based on Siegel's criteria, 8 patients (8.98 %) had complete recovery, 14 (15.73 %) had partial recovery, 16 (17.98 %) had slight recovery, and 51 (57.31 %) had no improvement. Older age (odds ratio [OR] = 0.970, 95 % confidence interval [CI]: 0.941-0.999, p = 0.043) and profound hearing loss on pure-tone audiometry (PTA; OR = 0.058, 95 % CI: 0.007-0.462, p < 0.001) were adverse prognostic factors in univariate analyses. Older age (OR = 0.963, 95 % CI: 0.932-0.994, p = 0.023) and profound hearing loss (OR = 0.048, 95 % CI: 0.005-0.395, p = 0.004) were independent negative prognostic factors in a multivariate analysis.

Conclusions: ITSI is effective and avoids side effects of high-dose steroids in patients with SSNHL and DM. Among 89 DM SSNHL patients who underwent ITSI, older age and profound hearing loss were negative prognostic factors. Prompt and active management is necessary for DM patients with these risk factors.

Keywords: Diabetes mellitus; Intra-tympanic steroid injection; Prognostic risk factor; Sudden sensorineural hearing loss.