Intratympanic steroid therapy for refractory sudden sensory hearing loss: a 12-year experience with the Silverstein catheter

Abstract

Background: Sudden sensorineural hearing loss (SSNHL) is commonly encountered in clinical practice.Aim/Objective: Determine if local administration of corticosteroids to the inner ear can improve hearing and speech intelligibility after the failure of conventional treatment for SSNHL loss when administered for 10 days after the onset of the hearing loss in a large cohort of 77 patients.Materials and methods: A Silverstein MicroWick™ was placed under local anesthesia and endoscopic control in the round window niche, allowing self-administration of methylprednisolone twice daily for four weeks.Results: An improvement of the pure tone average was shown in 31% of patients. Speech intelligibility improved significantly in 55% of the total cohort and in 34% of the population with a stable pure tone average. Among the 77 patients, 22% used a hearing aid. Only 14% of the patients were hearing-aid users in the group with an improvement in speech intelligibility as opposed to 31% in the failure group.Conclusion and significance: Local administration of steroids to the inner ear through the round window route improves hearing and speech intelligibility in patients after failure of conventional therapy. The use of a hearing aid was reduced by 50% when speech intelligibility was improved.