Hearing Efficacy of Intratympanic Methylprednisolone Perfusion for Severe and Profound Sudden Sensorineural Hearing Loss

Abstract

Objectives: Investigate the efficacy of intratympanic methylprednisolone perfusion (IMP) for severe and profound sudden sensorineural hearing loss (SSNHL). Methods: Hearing recovery was analyzed retrospectively in SSNHL patients, who received IMP after not fully responding to conventional treatments and were hospitalized in our department between January 2008 and December 2012. Results: Eighty-seven patients with SSNHL were divided into 4 types according to primary hearing curve: total deafness (77.01%), mild to moderate hearing loss in all frequencies (18.39%), hearing loss in low-tone frequencies (2.30%), and hearing loss in high-tone frequencies (2.30%). The effective rate was 66.7% and average pure tone average (PTA) improvements were 18.53 ± 13.54 dB in the patients of interval from onset to IMP within 15 days, 21.2% and 5.92 ± 15.18 dB in the patients of interval between 16 and 30 days, 4.8% and 3.69 ± 7.00 dB in the patients of interval more than 30 days, respectively. The effective rate had significant differences among the 3 different interval groups (χ2 = 25.91, P = .000), and the PTA improvements in the patients of interval within 15 days were the best in the 3 groups ( F = 11.182， P = .000). A total of 30 cases were responsive to IMP, one of them was hearing loss in low tone frequencies and the other 29 cases were in all frequencies. The average hearing improvements in the lower 3 frequencies (0.25 kHz-1 kHz)were better than those in the higher 3 frequencies (2 kHz-8 kHz; F = 9.494, P = .000). Conclusions: Receiving IMP earlier may help to improve hearing recovery for the patients with SSNHL not fully responding to conventional treatments. The hearing improvements in the lower frequencies may be better than those in the higher frequencies after IMP.