Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation.
OBJECTIVE
To discuss the value of intratympanic dexamethasone (IT-DEX) perfusion for sudden sensorineural hearing loss (SSNHL), clinically and in an animal model.


METHODS
Retrospective case review of 10 patients with SSNHL treated with IT-DEX. The findings are correlated with this institution's previous findings from a study of IT-DEX in guinea pigs.


METHODS
Ambulatory tertiary otologic referral center.


METHODS
Sequential patients with SSNHL who chose IT-DEX treatment.


METHODS
Dexamethasone 0.5 mg was injected transtympanically and bathed the round window for 20 minutes. Animal study: 79 ears were randomized into five groups: control, IT-DEX versus intravenous (IV)-DEX, IT-DEX with histamine, IT-DEX with hyaluronic acid, and IT-DEX with dimethylsulfoxide.


METHODS
Clinical study: postprocedure audiometry. Animal study: perilymph steroid concentration.


RESULTS
IT-DEX results in significant hearing improvement and in significantly higher perilymph concentration of steroid than IV-DEX.


CONCLUSIONS
IT-DEX is an appropriate treatment option for the treatment of SSNHL. Further study of dosages and frequency of administration is warranted.
Chandrasekhar
S S
SS
Division of Otolaryngology-HNS, UMDNJ-New Jersey Medical School and University Hospital, Newark, USA.
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004334:Drug Administration Schedule; D005260:Female; D006168:Guinea Pigs; D003639:Hearing Loss, Sudden / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D012189:Retrospective Studies; D013067:Speech Perception / Q000502:physiology; D013069:Speech Reception Threshold Test; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone