Intratympanic Steroids Partially Restore Hearing Loss

A new study shows that the use of intratympanic steroid injections in patients with sudden sensorineural hearing loss (SSNHL) can partially restore the hearing degradation.

European researchers from the Hospital de Fuenlabrada (Madrid, Spain) and Fundación Hospital Alcorcón (Madrid, Spain) conducted a non-randomized prospective clinical trial of 50 patients diagnosed with unilateral SSNHL due to unknown reasons. All cases were intravenously treated with 120 mg of methlyprednisolone per day for five days. After five days of intravenous treatment, pure-tone audiometry (PTA) and speech discrimination tests (SDT) were performed.

After this period of intravenous therapy, failures (18 cases) were offered intratympanic steroid treatment. Nine patients refused, and they were treated with oral steroid tapering for 15 days. They were considered as internal controls, whereas the other nine patients received three weekly intratympanic injections of methylprednisolone. The Intratympanic steroid treatment was started five to seven days after the onset of conservative treatment, and PTA and SDT were performed throughout on both groups up to six months later.

Among the 18 failures in the treatment group, hearing improvement of 15 decibels (dBs) or more in PTA was noted in five cases (55%). The mean value of PTA before and one month after intratympanic injections treatment were 73.3 ± 20.8 dB and 40.2 ± 17.3 dB, respectively, so that an improvement in mean PTA after intratympanic treatment was 33 ± 12.55 dB. The findings were presented at the 110th annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation, held in September 2006 in Toronto (Canada).

"The number of injections, the type of steroid, and the most adequate doses must be defined in randomized prospective clinical trials. Also, these randomized studies will allow establishing an evidence-based treatment for idiopathic SSNHL,” concluded the authors, Guillermo Plaza M.D., Ph.D, and Carlos Herráiz M.D., Ph.D.

SSNHL can occur suddenly in one ear, and generally within three days, it can cause a 30+ dB hearing loss at three consecutive frequencies. The cause for this disorder is unclear, but research has indicated that viral infection, vascular compromise, and immunologic diseases could be key reasons for this hearing disorder.



Related Links:
Hospital de Fuenlabrada
Fundación Hospital Alcorcón