Abstract
Objective: Evaluate hearing recovery following local application of insulin-like growth factor 1 (IGF1) in patients with sudden sensorineural hearing loss (SSHL) that was refractory to systemic steroids. Method: Subjects were 25 patients with SSHL showing no hearing recovery following systemic steroid treatment. We applied gelatin hydrogels, impregnated with IGF1, into the round window niche, and examined alterations in pure tone audiometry and evoked otoacoustic emission over time. Results: In total, 25 patients received the test treatment at a median of 23 days after the onset of SSHL. Before the test treatment, the mean hearing level at the 5 frequencies tested was 81.2 dB. At 24 weeks after the test treatment, 11.9 dB recovery in the mean hearing level was found. Statistically significant recovery was identified at 0.5 kHz (16.6 dB). Hearing recovery of more than 10 dB in pure tone audiometry appeared within 4 weeks after the test treatment and saturated. Four patients showed the recovery in evoked otoacoustic emission together with hearing recovery in pure tone audiometry. Conclusion: Local IGF1 application via gelatin hydrogels may be efficacious for hearing recovery in patients with SSHL that is resistant to systemic steroids, and induces recovery of outer hair cell function similarly to previous findings in animal experiments.
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