Intratympanic Dexamethasone Injection Research Articles

Investigating the Effect of Coenzyme Q10 in the Treatment of Sudden Sensorineural Hearing Loss

Background and Objective: Sudden sensorineural hearing loss (SSNHL) is a complication that is usually unilateral and can be accompanied by tinnitus and vertigo. Although various infectious, vascular, and immune etiologies have been proposed for SSNHL, the cause is unknown in most cases. Therefore, this study aimed to determine the effect of coenzyme Q10 in the treatment of SSNHL. Materials and Methods: This study was a double-blind, randomized, controlled clinical trial, which was conducted using the available sampling method. A total of 60 patients with SSNHL (18-70 years old) lasting less than one month were divided into two groups: intervention and control. The routine treatment of both groups included weekly injections of dexamethasone in the middle ear for 3 weeks. The intervention group also received 100 mg of coenzyme Q10 per day for 4 weeks, while the control group received a placebo. Patients were evaluated by basic audiological tests at the baseline and third and sixth months after the treatment. Statistical analysis of findings was done in SPSS26 software. Results: The difference in the mean pure tone hearing thresholds of the intervention and control groups was significant in the third month (29.33±15.96 dB and 35.34±12.24 dB; P=0.02) and sixth month (dB 28.00±16.27 and dB 34.33±11.87; P=0.01). Conclusion: In patients with SSNHL, combined treatment with oral coenzyme Q10 at the rate of 100 mg per day, along with intratympanic injection of dexamethasone for four weeks, can improve pure tone hearing thresholds and facilitate the treatment

The anterior inferior cerebellar artery abutment: an uninvited guest in sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SSNHL) is an otological emergency and prompt recognition and management has been shown to improve hearing outcomes and quality of life. A 49-year-old female presented to the ENT OPD with complaints of sudden onset decreased hearing in the right ear since 3 days. Pure tone audiometry done in an outside hospital on day 2 of patient’s complaints showed right ear to have pure tone average of 90 dB (profound hearing loss) and left ear to have pure tone average of 21.66 dB (within normal limits). At presentation to the ENT OPD on day 3 of complaints, otoscopic examination revealed normal tympanic membrane. MRI inner ear and brain (plain and contrast) showed the right anterior inferior cerebellar artery to be abutting the posterior aspect of vestibulocochlear nerve. Patient received 2 doses of intratympanic injection of Dexamethasone followed by a course of oral steroids for 15 days. Serial repeat pure tone audiometry showed marked improvement of symptoms. Although most cases of SSNHL are idiopathic, a number of treatable conditions do exist. The relationship between vascular loops around the vestibulocochlear nerve and sudden sensorineural hearing loss have to be kept in mind while evaluating these patients. Prognosis for hearing recovery is based on several factors, including time since onset, degree of deafness, age, and vertigo. Although SSNHL will often spontaneously improve without treatment, directed therapy against treatable causes along with steroid therapy can aid in the improvement of symptoms.

Easing the Burden of Tinnitus: A Narrative Review for Exploring Effective Pharmacological Strategies.

Many individuals seek medical attention for tinnitus, desiring relief from the distress caused by the condition; however, the treatment process is far from straightforward. The most effective treatments for chronic subjective tinnitus, such as tinnitus retraining therapy (TRT) and cognitive behavioral therapy (CBT), require considerable time and efforts. As a result, many of them express a desire for alleviation through medication. While it is true that medication is not generally recommended in treatment guidelines for chronic subjective tinnitus, in specific situations such as when accompanied by symptoms of depression or anxiety-drugs like antidepressants or anxiolytics may have a meaningful impact on symptom reduction. Additionally, medication can prove effective in certain specialized forms of tinnitus, such as typewriter tinnitus, as opposed to chronic subjective tinnitus. Although intratympanic dexamethasone injections for tinnitus have been reported to lack efficacy compared to a placebo, if patients perceive subjective satisfaction due to a placebo effect, it holds significance. From the perspective of patients suffering from tinnitus, even if the therapeutic mechanism is set aside, experiencing some degree of relief through certain medications can enhance compliance with evidence-based treatments like TRT and CBT.

Comparison of Batroxobin Versus the Combination of Batroxobin and Intratympanic Dexamethasone Injection in the Treatment of Sudden Sensorineural Hearing Loss.

Introduction: Sudden sensorineural hearing loss (SSNHL) manifests as an abrupt decline in hearing by at least 30 dB within a 3 day period. Intratympanic dexamethasone injection (ITDI) has gained recognition as a potential treatment for SSNHL. This study aims to investigate the efficacy of combining batroxobin with ITDI (Bat and ITDI) in treating SSNHL patients and its influence on peripheral blood inflammatory indicators. Methods: SSNHL patients were retrospectively categorized into the control group (treated with Bat) and the observation group (treated with Bat and ITDI). The study involved analyzing clinical baseline data, evaluating clinical efficacy, and comparing the total effective rates among SSNHL patients with different audiometric curve types in the observation group. Routine blood tests were performed on peripheral blood samples to calculate the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), and to determine C-reactive protein (CRP) levels. Adverse reactions and complications were closely monitored. Results: Following treatment, both groups displayed improvements in hearing, with the observation group exhibiting a significantly higher total effective rate (75.90%) than the control group (59.78%). For patients with 3 distinct types of sudden hearing loss (high-frequency, flat-frequency, total deafness), Bat and ITDI treatment demonstrated increased total effective rate for patients with different sudden hearing loss types (high-frequency, flat-frequency, and total deafness). Both groups experienced reduced peripheral blood CRP levels and the NLR/PLR values, with the observation group demonstrating lower values. Additionally, across the 4 audio metric subtypes, the levels of peripheral blood CRP, NLR, and PLR decreased in SSNHL patients, and the observation group had a lower incidence of adverse reactions compared to the control group. Conclusions: Bat and ITDI emerge as notably more effective for SSNHL patients, displaying potential for reducing peripheral blood inflammatory indicator levels and mitigating the incidence of adverse reactions or complications, thereby enhancing safety.

Prognostic factors of sudden sensorineural hearing loss

Background: Sudden sensorineural hearing loss (SSNHL) refers to rapid and often unexplained decline in auditory acuity. Reported recovery rates for SSNHL vary across studies; however, these are usually within the range of 40% to 60%. Although numerous studies have investigated factors that affect auditory restoration, prediction of patients’ hearing recovery remains challenging.Current Concepts: Natural recovery rates for SSNHL range between 32.0% and 65.0%, and treatments commonly include systemic steroid therapy and intratympanic dexamethasone injections. Adjunctive treatments, such as antiviral agents, vasodilators, anticoagulants, hyperbaric oxygen therapy, and stellate ganglion block therapy are also utilized. Recovery typically occurs within 2 weeks, and approximately 66.0% of patients have complete or partial hearing restoration. Recovery predominantly occurs early; approximately 78.2% to 90.0% patients recover within 1 month and >98.0% within 3 months. Age is an important factor associated with recovery; patients aged ≥40 years show low recovery rates. Coexisting dizziness is generally associated with unfavorable outcomes. Hearing loss severity and types (based on the frequency-specific pattern of hearing impairment) are associated with poor prognosis. Additionally, systemic conditions like hypertension and diabetes are implicated as etiopathogenetic contributors. In addition to a variety of audiological assessments to evaluate cochlear function, environmental factors, including particulate matter and air pollution affect outcomes.Discussion and Conclusion: During SSNHL treatment, evaluation of factors known to affect recovery is important to determine patients’ hearing restoration potential. Proactive patient counseling is necessary to guide treatment decision-making, particularly for initiation of auditory rehabilitation following incomplete or lack of recovery. Significant variables that affect hearing recovery are useful prognostic indicators. These studies are expected to provide better understanding of the pathophysiology of SSNHL and offer an evidence-based foundation for therapeutic interventions.

A Basilar Artery Dissection Mimicking Acute Labyrinthitis in A 15-Year-Old Girl

Basilar artery dissection (BAD) is a rare cause of vertigo in children. A 15-year-old girl presented with sudden vertigo and unilateral hearing loss. Magnetic resonance imaging revealed posterior circulation infarction caused by BAD. After antiplatelet therapy, intratympanic injections of dexamethasone and vestibular rehabilitation, her symptoms improved. We report this case of BAD, which might be mistaken for acute peripheral vestibular disorders in the early stage.

Primary versus salvage intratympanic steroid treatment for idiopathic sudden sensorineural hearing loss.

The objective of this research is to compare primary and salvage intratympanic (IT) steroid treatments in terms of hearing outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). The patients were randomized into two (primary and salvage) groups. Both groups received systemic steroid treatment for 2 weeks. The primary group also received IT dexamethasone injection three times during the treatment period, whereas the salvage group received IT dexamethasone injection only if no or slight recovery was noted at the 2-week follow-up. If needed, salvage steroid injection was administered three times during the following 2 weeks. Hearing recovery was analyzed according to the modified American Academy of Otolaryngology-Head and Neck Surgery criteria. The degrees of hearing improvement at the 3-month follow-up were similar in the two groups. Compared with baseline, the pure-tone average values and speech discrimination scores improved by 38.45 ± 21.95 dB HL and 34.32% ± 30.55%, respectively, in the primary group and 36.80 ± 22.33 dB HL and 31.87% ± 27.88%, respectively, in the salvage group (p = .762 and .659, respectively). In addition, the complete or partial hearing recovery rates were also similar in the primary and salvage groups (67.7% vs. 73.3%, respectively; p = .780). In the salvage group, 18 patients required no IT steroid injection because they recovered after systemic steroid treatment. Primary and salvage IT steroid treatments for ISSNHL led to similar outcomes. In summary, salvage IT steroid injection is recommended for patients with ISSNHL patients to prevent unnecessary IT injection. 2.

Menière's Syndrome Associated With Fibrous Dysplasia of the Temporal Bone.

Menière's Syndrome Associated With Fibrous Dysplasia of the Temporal Bone.

Treatment of Tinnitus with Intratympanic Injection of Dexamethasone Versus Oral Drugs.

Tinnitus is a symptom of cochlear dysfunction, which can disturb the patient emotionally and physically. As anxiety and tinnitus persist concurrently, certain benzodiazepines have been administered as possible tinnitus treatment options. In addition to pharmacological medications, certain studies have looked at the use of vitamins to treat tinnitus. Intratympanic steroids have been successfully used in various studies as well, for the treatment of tinnitus. A clinical based interventional study was taken up among the patients visiting the ENT OPD of a State Medical College and Hospital. 160 subjects were included in the study by convenient sampling method, taking the inclusion and the exclusion criteria into consideration. Out of them, 80 subjects were given an intratympanic injection of dexamethasone and rest 80 were given oral drugs like alprazolam and vitamin B complex. Among the patients who were treated with intratympanic dexamethasone, significant improvement was seen in 36 of them, with a p value of 0.00 as compared to those who were given oral drugs, in which only 10 showed improvement, with a p value of 0.32. The improvement of the symptoms is significantly related with the duration of the symptoms in our study. Patients presenting with severe SNHL was the commonest presentation but had the least improvement (29.6%). Patients presenting within one year of occurrence of the symptoms had maximum improvement. Intratympanic dexamethasone can be considered as a good alternative for improvement of symptoms of tinnitus.

Hearing loss and COVID-19: an umbrella review.

COVID-19 can result in an extensive range of extrapulmonary, and neurological signs and symptoms such as olfactory and/or taste dysfunction, and otologic symptoms. The aim of this study was to investigate the hearing loss manifestation from COVID-19. The goal of this umbrella review was to examine hearing loss associated with COVID-19 disease. English literature published until October 15, 2022 in online databases including PubMed, Scopus, Web of Science, and Embase was considered for this purpose. Eligibility of the articles for subsequent data extraction was evaluated in a two-step selection process with consideration to an inclusion/exclusion criterion. This review followed the PRISMA protocol and the Amstar-2 checklist for quality assessment. A total of four treatment strategies were used by different studies which included oral corticosteroids, intratympanic corticosteroids, combined oral and intratympanic corticosteroids, and hyperbaric oxygen therapy. Five studies investigated corticosteroid use in the forms of oral or intratympanic injection; four studies reported (complete or partial) hearing improvements after steroid treatment, while one study stated no significant improvement in hearing function. One study reported that oral corticosteroid monotherapy alone was not effective, while vestibular symptoms were ameliorated by a combination of oral prednisone, intratympanic dexamethasone injection, and hydroxychloroquine. The findings suggest that despite being one of the rare complications of COVID-19, hearing loss can impact a patient's quality of life. The most common type reported was sensorineural hearing loss, which can be diagnosed with variable techniques.

Evaluation of Sudden Sensory-Neural Hearing Loss Patients Treated with Systemic Steroids with Additional Intratympanic Dexamethasone Injection in Different Intervals; a Clinical Trial Study.

The online version contains supplementary material available at 10.1007/s12070-023-03641-4.

Clinical Factors Associated With Prognosis of Tinnitus and Aural Fullness After Sudden Sensorineural Hearing Loss.

We evaluated the long-term prognosis and risk factors associated with tinnitus and aural fullness, which occurred with sudden sensorineural hearing loss. Retrospective cross-sectional review. Tertiary referral center. Those who visited our clinic for sudden hearing loss from January 2016 to May 2020, diagnosed with sudden sensorineural hearing loss based on pure-tone audiometry, and underwent magnetic resonance imaging to rule out other cause of hearing loss. In total, 106 patients were enrolled in this study. All patients were treated with oral glucocorticoids. Salvage intratympanic dexamethasone injection therapy was performed for the patients whose hearing was not fully recovered. We scored the loudness of tinnitus and the intensity of aural fullness using the numerical rating scale. We used a mixed-effects model for repeatedly measured tinnitus and aural fullness scores. The time after the onset of sudden sensorineural hearing loss (SSNHL; β = -0.07; 95% confidence interval, -0.09 to -0.05; p < 0.001) and hearing outcome after treatment (overall p = 0.003) were significant factors associated with the prognosis of tinnitus. Concerning aural fullness, the time after the onset of SSNHL was a significant prognosis factor ( β = -0.08; 95% confidence interval, -0.09 to -0.06; p < 0.001), unlike hearing outcome (overall p = 0.261). Pretreatment pure-tone audiometry average threshold and mainly affected frequencies were not significant factors for tinnitus and aural fullness recovery, respectively. The persistence of tinnitus with SSNHL was significantly affected by hearing recovery after treatment, whereas aural fullness was not associated with hearing recovery. However, both symptoms were improved over time after SSNHL.

Efficacy of Oral versus Intratympanic Steroids in the Treatment of Idiopathic Sudden Sensorineural Hearing Loss: A 1-year Randomized Control Trial

Background: Sudden sensorineural hearing loss (SSNHL) is a common otologic emergency, with hearing loss of 30 dB or greater at three contiguous frequencies, and an abrupt onset within 3 days or fewer, with no recognizable cause. Aims and Objectives: In this study, the efficacy of intratympanic (IT) injections of dexamethasone are compared with oral prednisolone and the behaviour of the different audiometric curves in response to both the steroid therapies in studied. Materials and Methods: Patients presenting with SSNHL to the Department of ENT, Head and Neck Surgery at Government Multi Speciality Hospital, Chandigarh, were subjected to routine tests. Informed written consent was taken from each patient, and cases meeting the selection criteria were included in the study. Pure-tone audiometry was done before starting treatment. Patients were randomly assigned into two groups based on their enrollment number. Those in Group 1 were treated with three doses of 0.3–0.6 mL IT injections of dexamethasone (4 mg/mL) on alternate days and those in Group 2 received OP 1 mg/kg/day with tapering doses. Pure-tone audiogram (PTA) will be repeated after 2 weeks, 4 weeks, and 8 weeks from the first dose. Results: In the IT dexamethasone group, the pretreatment PTA was 61.05 dB while the posttreatment PTA was 37.45 dB. The hearing gain was 23.6 dB. In the oral steroid group, pretreatment PTA was 66.79 while posttreatment PTA was 47.36 dB. The hearing gain was 19.43 dB. The hearing gain in both the groups was statistically significant; however, there was no statistical difference between the two in terms of superiority of efficacy (P &gt; 0.05). Conclusion: The treatment of SSNHL still remains a challenge among the otologists. The present study establishes that the efficacy of IT steroids was as good as the oral steroid therapy for the management of SSNHL as both the modalities showed significant hearing improvement. Hence, IT steroid can be used as a first-line therapy in patients with. Our study also uncovered the fact that patients who come with shorter duration of onset recover quickly compared to those patients who delay their treatment. Hence, IT steroid can be used as a primary modality of treatment instead of a salvage therapy in the selected group of patients.

A COMPARATIVE STUDY ON EFFICACY OF ORAL AND INTRATYMPANIC STEROIDS IN SUBJECTIVE IDIOPATHIC TINNITUS

Background: Tinnitus is a common and annoying symptom caused by an abnormal spontaneous activity from within the auditory system. Corticosteroids is used as an empirical treatment in the oral form or as intratympanic injection for the treatment of this chronic condition. Aim of the study: To evaluate the efficacy of Intratympanic dexamethasone injection and oral prednisolone in the treatment of subjective idiopathic tinnitus. Materials and Methods: This is an interventional study carried out at Madurai Medical College for a period of one year. A total of 60 patients with subjective idiopathic tinnitus were included of which 30 patients were subjected to Intratympanic Dexamethasone injection and 30 patients were given oral prednisolone. Improvement in the symptom of tinnitus was assessed by means of subjective evaluation with the help of Tinnitus Handicap Inventory (THI) before and after 1 week, 1 month and 3 months of treatment. Results: There was a significant reduction in the mean THI SCORE and the grade of THI at 1 month and 3 months after treatment with both oral steroids and intratympanic steroids. Conclusion: Intratympanic steroids and oral steroids can be considered as viable options for the treatment of subjective idiopathic tinnitus although intratympanic steroid is a better alternative as it bypasses the systemic side effects of steroids.

Intratympanic injection of dexamethasone for management of labyrinthitis associated with COVID-19 disease resistant cases

ObjectiveTo evaluate the efficacy of mixed oral prednisolone and intratympanic dexamethasone (ITID) injection in labyrinthitis, due to COVID 19. MethodsSeventy-five post-COVID-19 labyrinthitis patients were included. Those patients were treated with systemic oral prednisolone for two weeks and ITID. Patients who refuse ITID were ordered to continue oral prednisolone treatment. Assessment of outcome and audiometry for hearing evaluation was done 1, 2 and 4 weeks as well as 3 months post-treatment. ResultsPatients in oral steroid only group were 26 patients, while patients in oral steroid and ITID group were 49 patients. In oral steroid group; 11/26 patients showed complete recovery, 3/26 had partial recovery and 12/26 not recovered. In other group; 38/46 patients had complete recovery, 6 had partial recovery and 5/49 patients not recovered. ConclusionCombined systemic corticosteroid with ITID showed a marked improvement of post-COVID vestibular disorder and hearing loss than only using oral corticosteroid therapy.

AB211. SOH22ABS077. Intratympanic dexamethasone injection for tinnitus

Background: Tinnitus affects over 60% of people at some stage of their lives and are often short-lived. A small cohort of patients experience intractable debilitating tinnitus, unrelated to hearing loss or vertigo syndromes. Management strategies include tinnitus masking techniques, cognitive behavioural therapy, and more recently, neuromodulation. Intratympanic dexamethasone injection for intractable tinnitus has been described although the evidence for such intervention is not strong.

Duration of symptom control following intratympanic dexamethasone injections in Meniere’s disease

PurposeIntratympanic (IT) injections of corticosteroids have emerged as a non-ablative alternative to gentamicin in the management of refractory Meniere’s disease. However, currently, the duration of the symptom control achieved via intratympanic corticosteroids is under reported.MethodsWe retrospectively reviewed the notes of all patients who underwent IT injections of dexamethasone for the treatment of definite Meniere’s disease at a single tertiary referral university centre over a 6-year period. We included demographic information, the number of procedures patients required, duration of symptom-control achieved (time interval between repeat IT injections), and the presence of co-morbidities, with a focus on the presence of autoimmune disease.ResultsWe identified 27 patients who underwent a total of 42 procedures; 23/27 (85.2%) patients demonstrated clinical response with a median period of symptom control of 14.5 months (range 1–64, IQR 10.25). The median longest asymptomatic period per patient was 19 months (range 11–64, IQR: 18). Interestingly, all patients with autoimmune disease (7/27) demonstrated a clinical response; autoimmune disease was found to be a statistically significant predictor of response to treatment (p = 0.002). In patients who received repeated treatment following disease relapse, there was no difference in duration of symptom-control achieved.ConclusionsIT steroids can provide an effective alternative to gentamicin ablation. Symptom control is achieved for a median of 14.5 months, and treatment can be repeated with no loss of efficacy. Those patients who have an underlying autoimmune co-morbidity are more likely to demonstrate a clinical response to therapy, which may provide insight into the underlying pathophysiology of Meniere’s disease.

Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min

BackgroundIntratympanic administration of gadolinium chelate allows for a better visualization of endolymphatic hydrops (EH) using MRI than intravenous injection and was recently further improved to facilitate high-quality imaging of EH in 7 min. The aim of the present study was to simplify the intratympanic administration protocol by mixing gadolinium chelate with therapeutic dexamethasone and to evaluate the effects of this mixture on the visualization of EH in MRI. Materials and methodsIn an in vitro study, the potential impact of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) on the stability of dexamethasone was evaluated by analyzing dynamic changes in dexamethasone with high-performance liquid chromatography (HPLC) after mixing with Gd-DTPA. Ten patients with definite Meniere's disease (MD) were recruited to study the potential interference of dexamethasone on MRI visualization of EH, and 49 patients with MD were recruited to evaluate the effect of intratympanic injection of Gd-DTPA mixed with dexamethasone on MRI of EH using a 3T MR machine and a novel heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed using a magnitude plus zero-filled interpolation (hT2FLAIR-MZFI) sequence. ResultsThe retention times and peak area of dexamethasone in HPLC were not modified by the addition of Gd-DTPA. EH grading in the cochlea and vestibule was not influenced in any ear by intratympanic injection of dexamethasone. Excellent inner ear images were obtained from all patients, and EHs with various grades were displayed. There were significant correlations between diagnosis and cochlear EH (p < 0.01, Spearman's Rho), between diagnosis and vestibular EH (p < 0.01, Spearman's Rho), and between cochlear and vestibular EH (p < 0.01, Spearman's Rho). The distribution of Gd-DTPA plus dexamethasone negatively correlated with the grade of vestibular EH. Injury of the endolymph-perilymph barrier was detected in one cochlea and three vestibules of 59 inner ears with MD. ConclusionsIntratympanic administration of Gd-DTPA plus dexamethasone yielded high-quality MRI images of EH in patients with MD using a novel 7-min protocol and simplified the clinical application. Intratympanic administration of Gd-DTPA plus dexamethasone might be used to test its therapeutic effect in future work. Level of evidence3.

Effectiveness of Intratympanic Dexamethasone Injection for Tinnitus Treatment: A Systematic Review and Meta-Analysis.

ObjectivesIntratympanic dexamethasone injection (ITDI) has been introduced as a treatment option for subjective tinnitus. However, the effects of ITDI on patients with tinnitus remain unclear. In the present systematic review and meta-analysis, we evaluated the effectiveness of ITDI for tinnitus treatment.MethodsWe searched Medline, the Cochrane Central Register of Controlled Trials, and Embase. Four double-blind randomized controlled trials that tested the efficacy of ITDI compared with a placebo were deemed eligible for a quantitative meta-analysis, while four prospective studies and seven retrospective studies reporting the effectiveness of ITDI on tinnitus treatment were included in a qualitative synthesis.ResultsIn the four studies included in the quantitative meta-analysis, ITDI did not show evidence of tinnitus improvement compared with placebo (odds ratio [OR], 1.38; 95% confidence interval, 0.53–3.61). In the 11 studies included in the qualitative synthesis, seven retrospective studies without controls reported rates of tinnitus improvement after ITDI ranging from 35.9% to 91.3%. In the four prospective studies with controls, ITDI seemed to be effective when combined with other drugs for tinnitus treatment.ConclusionITDI alone did not show a significant effect for treating tinnitus compared with placebo. However, the potential of combination treatment of ITDI with other drugs for tinnitus therapy should be further studied in more systematic research.

Frequency-specific prediction model of hearing outcomes in patients with idiopathic sudden sensorineural hearing loss.

The hearing outcome of idiopathic sudden sensorineural hearing loss (ISSNHL) is hard to predict. We herein constructed a multiple regression model for hearing outcomes in each frequency separately in an attempt to achieve practical prediction in ISSNHL. We enrolled 235 consecutive in-patients with ISSNHL who were treated in our department from 2015 to 2020 (average hearing level at 250-4000Hz ≥ 40dB; time from onset to treatment ≤ 14days; 126 males/109 females; age range 17-87years (average 61.0years)). All patients received systemic prednisolone administration combined with intratympanic dexamethasone injection. The pure-tone hearing threshold of 125-8000Hz was measured at every octave before (HLpre) and after (HLpost) treatment. A multiple regression model was constructed for HLpost (dependent variable) using five explanatory variables (age, days from onset to treatment, presence of vertigo, HLpre, and hearing level of the contralateral ear). The multiple correlation coefficient increased as the frequency increased. Strong correlations were seen in high frequencies, with multiple correlation coefficients of 0.784/0.830 for 4000/8000Hz. The width of the 70% prediction interval was narrower for 4000/8000Hz (± 18.2/16.3dB) than for low to mid-frequencies. Among the five explanatory variables, HLpre showed the largest partial correlation coefficient for any frequency. The partial correlation coefficient for HLpre increased as the frequency increased, which may partially explain the high multiple correlation coefficients for high frequencies. The present model would be of practical use for predicting hearing outcomes in high frequencies in patients with ISSNHL.