Intratympanic Steroid for the Management of Sudden Hearing Loss: Introduction of a Tapering Method

Introduction:Sudden sensorineural hearing loss (SSNHL) is a therapeutic challenge. There are several controversies regarding the management protocol of SSNHL. This study aimed to present the results of a novel treatment algorithm, which is a combination of systemic steroids and a tapering intratympanic (IT) dexamethasone regimen.Materials and Methods:The past ۱۰ years’ medical records of idiopathic SSNHL cases in Ghaem and Emamreza hospital, Mashhad University of Medical Sciences were evaluated. Patients were assessed using standardized methods for pure-tone threshold audiometry. The management method of SSNHL treatment included oral steroids combined with IT administration of dexamethasone once a day for ۷ days and continuing it on an alternate day and then weekly basis. Patients’ recovery was assessed using Siegel’s criteria.Results:This study included a total of ۲۴۸ cases of idiopathic sudden hearing loss, with a mean age of ۴۰.۶۳±۱۶.۱۹ years. In total, ۱۰۵ (۴۲.۳%) and ۱۴۳ (۵۷.۷%) patients were female and male, respectively. The most common associated symptoms included tinnitus (۸۶.۹%, n=۲۰۵) followed by vertigo (۵۲.۱%, n=۱۲۲). The final hearing outcome of patients showed that ۳۹ (۱۵.۷%), ۳۸(۱۵.۳%), ۸۶ (۳۴.۷%), and ۸۵ (۳۴.۳%) patients underwent a complete recovery, partial recovery, slight recovery, and no recovery, based on Siegel’s criteria.Conclusions:The dose, interval, and duration of IT steroid treatment were not universally approved. The treatment method designed based on a tapering of IT steroid injection in combination with already known systemic administration of steroids can be a treatment option in SSNHL patients. 

کلیدواژه ها:

Intratympanic ، steroid ، Sudden sensorineural hearing loss