Intratympanic methylprednisolone administration promotes the recovery of idiopathic sudden sensorineural hearing loss: a retrospective case-control study

Acta Otolaryngol. 2018 Nov;138(11):998-1003. doi: 10.1080/00016489.2018.1504170. Epub 2018 Nov 22.

Abstract

Background: Efficacy of current treatment methods in idiopathic sudden sensorineural hearing loss (ISSNHL) is still unsatisfactory.

Objective: This study aimed to discover in differences in effect between steroid applications responsible for promoting the prognosis in ISSNHL.

Materials and methods: A study was conducted to diagnose ISSNHL patients in our hospital from January 2014 to September 2016. All patients accepted treatments including intravenous injection (intravenous dexamethasone, [IV DXM]), intratympanic injection (intratympanic methylprednisolone [IT MP], intratympanic dexamethasone [IT DXM]) or combined injections with steroids (IV + IT DXM). Patients were divided into groups according to treatment outcomes and clinical characteristics of each group were compared for univariate comparison. Logistic regression was utilized to verify screening factors from univariate comparison for exclude biases.

Results: There were 313 patients with ISSNHL enrolled in the study. Logistic regression verified that vertigo (p = .023), severity of hearing loss (p=.969), pattern of hearing loss (p = .03), and the treatment method (p < .001) were statistically related to the patients' prognosis based on the condition all biases had been excluded as possible. IT MP showed a better prognosis of hearing improvement compared to treatment with IT DXM (OR = 0.5), IV DXM (OR =0.226), and IV DXM + IV DXM (OR = 0.320).

Conclusions and significance: IT MP treatment could be utilized as initial treatment in ISSNHL and might promote outcomes.

Keywords: Idiopathic sudden sensorineural hearing loss; intratympanic injection; methylprednisolone.

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Audiometry, Pure-Tone
  • Case-Control Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Glucocorticoids / administration & dosage*
  • Hearing Loss, Sensorineural / diagnosis
  • Hearing Loss, Sensorineural / drug therapy*
  • Hearing Loss, Sudden / diagnosis*
  • Hearing Loss, Sudden / drug therapy*
  • Humans
  • Infusions, Intravenous
  • Injection, Intratympanic
  • Male
  • Methylprednisolone / administration & dosage*
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Methylprednisolone