The Combination Effects of Early Intratympanic Dexamethasone Injection for Patients with Sudden Sensorineural Hearing Loss

Abstract

Objective: Intratympanic dexamethasone injection (ITDI) was generally used as salvage treatment for sudden sensorineural hearing loss (SSNHL) patients who failed initial systemic treatment or for patients who considered to have a hazard risk on systemic steroids. We investigated the effectiveness of combination therapy, early ITDI accompanied by systemic therapy on SSNHL. Method: We gathered the data of 151 SSNHL patients who were refractory to systemic treatment for 5 days. The injection group was administered systemic therapy and 4 times of ITDI within 2 weeks after break of SSNHL. The control group only received traditional treatment. We compared the last concrete hearing level and recovery rate. Results: Overall hearing improvement was observed in 47 of 104 (45.2%) control patients and in 30 of 47 (63.8%) injection patients ( P = .034). On the basis of Siegel criteria, 7 of 47 (14.9%) injection patients were recovered in Siegel criteria 1, and 10 of 47 (21.3%) and 13 of 47 (27.7%) injection patients were respectively recovered in Siegel criteria 2 and 3. In the control group, 15.4%, 8.7%, and 21.2% patients were recovered in Siegel criteria 1, 2, and 3, respectively. Depending on the degree of initial hearing loss, patients with severe hearing loss who were treated with ITDI showed significantly higher recovery rates than patients in the control group (83.8% vs 50.0%) ( P = .049). Conclusion: Early combination therapy of intratympanic dexamethasone injection within 2 weeks accompanied by initial systemic treatment is effective for patients with refractory sudden sensorineural hearing loss, especially for patients with severe hearing loss.