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Abstract
Treatment in sudden sensorineural hearing loss is a contentious issue, today, oral steroids are the most common choice and considered the best treatment option, but the use of intratympanic steroids has become an attractive alternative, especially in cases when systemic therapy fails, or to avoid the side effects of the systemic use of steroids. AimTo describe the results of intratympanic methylprednisolone in idiopathic sudden sensorineural hearing loss after failure of oral prednisolone. MethodsIn a prospective study fourteen patients with idiopathic sudden sensorineural hearing loss were treated with intratympanic methylprednisolone after failing in the treatment with systemic steroids. Pretreatment and post-treatment audiometric evaluations including pure tone average (PTA) and speech reception thresholds (SRT) were analyzed. ResultsTen from 14 patients treated with intra-tympanic methylprednisolone presented with hearing recovery > 20 dB in PTA or 20% in SRT. ConclusionThree intratympanic injections of methylprednisolone improved pure-tone average or speech discrimination scores for a subset of sudden hearing loss subjects that failed to benefit from oral steroids.
Highlights
Sudden hearing loss (SHL) may be defined as hearing loss of 30dB or more that occurs within three days, and affects three or more frequencies.[1]
Three intratympanic injections of methylprednisolone improved pure-tone average or speech discrimination scores for a subset of sudden hearing loss subjects that failed to benefit from oral steroids
Comorbidities included systemic arterial hypertension (SAH) or type 2 diabetes mellitus (DM), which were present in 5 patients, of which three patients had SAH and type 2 DM, and two had a history of increased intraocular pressure
Summary
Sudden hearing loss (SHL) may be defined as hearing loss of 30dB or more that occurs within three days, and affects three or more frequencies.[1]. The true incidence of SHL in Brazil is probably underestimated because many patients recover their hearing within a few days and generally do not seek medical care. This entity is not one of the most common causes of deafness, interest in studying it remains low, probably due to its reversible nature in most cases.[3]. The actual number of patients that recover spontaneously from SHL without medical treatment remains unknown. The elevated rate of spontaneous recovery - over 65% in some studies - confounds the reviews on the efficacy of a single drug or a new intervention. The treatment of SHL patients varies among otology units, and there is no universally accepted protocol
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