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Effectiveness of Intratympanic Dexamethasone Injection in Sudden‐Deafness Patients as Salvage Treatment
Author(s) -
GuanMin Ho,
HungChing Lin,
MinTsan Shu,
ChengChien Yang,
HsunTien Tsai
Publication year - 2004
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200407000-00010
Subject(s) - medicine , dexamethasone , audiometry , randomized controlled trial , absolute threshold of hearing , anesthesia , pure tone audiometry , hearing loss , surgery , audiology
Objective: To study the effectiveness of intratym‐panic dexamethasone (IT‐DEX) in patients with severe or profound sudden sensorineural hearing loss (SSNHL) after treatment failure with conventional therapy. Study Design: Randomized, controlled study. Methods: Patients who met the criteria for SSNHL, with a severity of severe to profound, underwent 10 days of standard treatment with oral steroid and other facilitating agents. Patients showing poor response to standard treatment were assigned randomly to a control group or to a group receiving IT‐DEX. IT‐DEX injections were performed once a week for 3 consecutive weeks. Pure‐tone audiometry was obtained before each injection. Minimum follow‐up time was 1 month. Successful treatment was defined as a hearing improvement of greater than 30 dB. Results: Thirty‐nine patients meeting the inclusion criteria were studied. After treatment with oral steroid, 10 of 39 (26%) patients demonstrated hearing improvement, whereas the remaining 29 (74%) patients showed a hearing improvement of less than 30 dB. For those without hearing improvement, 15 received IT‐DEX, and 14 received further standard treatment (except oral steroid and carbogen inhalation). Hearing improved in 8 of 15 (53.3%) compared with 1 of 14 (7.1%), with an average decrease in threshold of 28.4 dB and 13.2 dB for the IT‐DEX group and the control group, respectively ( P < .05). Prognostic factors such as age, treatment delay time, and sex did not significantly affect the response to therapy. Conclusions: IT‐DEX injection effectively improves hearing in patients with severe or profound SSNHL after treatment failure with standard therapy and is not associated with major side effects. It is therefore a reasonable alternative as salvage treatment.