Intratympanic Dexamethasone and HBO for Sudden Hearing Loss

Abstract

Objective: The objective of this study is to compare the efficacies of intratympanic dexamethasone (ITD), hyperbaric oxygen (HBO), and their combination (ITD plus HBO) as salvage therapies for sudden sensorineural hearing loss (SSNHL) patients after failure of systemic therapy. Method: Ninety-seven refractory SSNHL patients are enrolled in this study. Among them, 34 received ITD alone, 19 received HBO alone, 13 received a combination of ITD plus HBO, and 31 did not receive salvage therapies. The hearing outcome is determined by hearing gains between the audiometry before and after salvage therapies. Results: Combination of ITD and HBO provides significantly greater hearing gain in 250 Hz and 500 Hz than the other 3 groups ( P < .05). Besides, in patients with initial profound hearing loss (>90 dBHL), the addition of HBO to ITD has a significantly larger hearing gain in mean thresholds of 500, 1000, 2000, and 4000 Hz (28.64 ± 3.49 dB) than ITD injection alone (15.75 ± 4.16 dB, P = .029) and without any salvage therapies (13.64 ± 6.05 dB, P = .015). Conclusion: For patients with profound hearing loss, we recommend a combination of ITD injection and HBO as salvage therapies after failure of systemic steroid therapy. The benefit is greatest especially in lower frequencies.