Intratympanic steroid injection for sudden sensorineural hearing loss: Impact of injection interval on therapeutic efficacy

Min Young Kwak; Chan Ju Yang; Hyun Joon Shim; Chan Il Song; Jong Yang Kim; Il Woo Lee; Sung Wook Jung; Hyun Woo Lim; Joong Keun Kwon; Jun Ho Lee; June Choi; Yun Suk An; Kyu-Yup Lee; Jong Woo Chung

doi:10.1016/j.anl.2020.06.009

Intratympanic steroid injection for sudden sensorineural hearing loss: Impact of injection interval on therapeutic efficacy

Auris Nasus Larynx. 2020 Dec;47(6):982-989. doi: 10.1016/j.anl.2020.06.009. Epub 2020 Jul 7.

Authors

Min Young Kwak¹, Chan Ju Yang², Hyun Joon Shim³, Chan Il Song⁴, Jong Yang Kim⁵, Il Woo Lee⁶, Sung Wook Jung⁷, Hyun Woo Lim⁸, Joong Keun Kwon⁹, Jun Ho Lee¹⁰, June Choi¹¹, Yun Suk An¹², Kyu-Yup Lee¹³, Jong Woo Chung¹⁴

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Otorhinolaryngology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
² Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
³ Department of Otorhinolaryngology-Head and Neck Surgery, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
⁴ Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
⁵ Department of Otolaryngology, National Police Hospital, Seoul, Korea.
⁶ Department of Otolaryngology, College of Medicine, Pusan National University, Busan, Korea.
⁷ Department of Otolaryngology and Head & Neck Surgery, College of Medicine, Dong-A University, Busan, Korea.
⁸ Department of Otolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
⁹ Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
¹⁰ Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
¹¹ Department of Otorhinolaryngology-Head and Neck Surgery, University College of Medicine, Seoul, Korea.
¹² Department of Otorhinolaryngology-Head and Neck Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
¹³ Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
¹⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: [email protected].

PMID: 32650961
DOI: 10.1016/j.anl.2020.06.009

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.

Keywords: Audiometry; Dexamethasone; Intratympanic; Sudden hearing loss.

Publication types

Comparative Study

MeSH terms

Adult
Analysis of Variance
Audiometry, Pure-Tone
Dexamethasone / administration & dosage*
Drug Administration Schedule
Female
Glucocorticoids / administration & dosage*
Hearing / drug effects
Hearing Loss, Sensorineural / drug therapy
Hearing Loss, Sudden / drug therapy*
Humans
Injection, Intratympanic
Male
Middle Aged
Retrospective Studies
Treatment Outcome

Substances

Glucocorticoids
Dexamethasone