Combined Intratympanic and Systemic Steroid Therapy in Sudden Sensorineural Hearing Loss.

Abstract

Sudden sensorineural hearing loss (SSNHL) is a true otological emergency that must be diagnosed and treated immediately. This study aimed to assess the efficacy of treatment with intratympanic dexamethasone (ITD) plus oral prednisolone with that of oral prednisolone or intratympanic dexamethasone alone and to determine factor affecting treatment outcome for SSNHL. Forty-five patients with SSNHL that had been present within 2weeks of onset of symptoms were included in this prospective case control study. Patients were allocated to three different groups. Patients in group A were treated with oral prednisolone 1mg/kg/d full dose 14days then tapered over next 14days. Patients in group B were treated with ITD 0.5ml (4mg/ml) every 7days for a total 4weeks along with oral prednisolone 1mg/kg/d in tapering dose for 4weeks. Patients in group C were got ITD 0.5ml (4mg/ml) every 7days for a total 4weeks. Audiogram was performed before each subsequent injection and at completion of treatment course. Among all participants, 22 patients (48.89%) showed improvement in pure tone audiogram to within 50% of pre- sudden hearing loss. On comparing the results of group A, B and C, there were no statistically significant difference with each other (p value 0.185). The mean audiometric gain was 37.71dB in recovered cases. The combination therapy of intratympanic dexamethasone and oral steroid is more effective in comparison with intratympanic or oral steroid alone in the treatment of SSNHL as the patients benefitted from the therapeutic effects of both local and systemic steroids.