The Evaluation of the Intratympanic Steroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss

Abstract

Recently, the gradual acceptance and performance of intratympanic (IT) steroid therapy for idiopathic sudden sensorineural hearing loss (ISSHNL) has been reported in Japan, but it has not yet become popular.We report herein on our results of IT steroid injections as initial therapy and salvage therapy for patients with ISSHNL.Methods:One hundred and thirty-four patients with ISSHNL treated in our institution were enrolled and analyzed. For the analysis of the effect of salvage therapy, patients showing poor response (hearing improvement <30 dB) to initial systemic steroid therapy were enrolled.Results:Fifteen patients were treated with IT steroid injection as initial therapy.In these patients, hearing improvement >10 dB and >30 dB were 86.7% and 60%, respectively. This hearing recovery was slightly better compared with the recovery of the patients on systemic steroid therapy as initial therapy.Seventy-eight patients were enrolled for the analysis of the effect of salvage therapy. Thirty-nine patients were treated with IT steroid injection as salvage therapy, 14 patients were treated with systemic steroid therapy, and in 25 patients no additional steroid therapy was performed. Compared with the latter two groups, patients in the IT steroid group achieved significantly better hearing recovery, especially those receiving IT steroid therapy within 3 weeks.Conclusions:IT steroid therapy for ISSHNL was considered an effective treatment as both initial and salvage therapy.There was a high degree of variability in the IT steroid therapy regarding frequency and intervals and the total number of injections across studies. Future studies are therefore required to elucidate the optimum protocol for IT steroid therapy.