Transtympanic corticoid therapy for acute profound hearing loss.
The prognosis of idiopathic sudden hearing loss depends on its severity; acute complete deafness, for example, has a particularly bad prognosis. The treatment of acute deafness is based on a systemic application of corticosteroids. Corticoid concentrations in the cochlea are higher after transtympanic application in comparison to systemic application. We therefore investigated whether an additional transtympanic corticoid therapy gives an advantage over systemic standard therapy. We report on 27 patients with sudden idiopathic profound hearing loss or deafness who were treated in the Department of Otorhinolaryngology, University of Essen, Germany. Fourteen patients were treated with a rheologic infusion therapy with systemic prednisolone. Thirteen patients were treated additionally with methylprednisolone (Urbason) transtympanically through a ventilation tube. In the first group of patients who were treated with infusion therapy and corticoids systemically, three patients had good recovery of hearing. Another five patients had a partial recovery of hearing. The average hearing gain from 0.5-4 kHz was 15 dB. In the group of patients who were treated additionally with local corticoids, two patients reported a good recovery of hearing and another two patients only had a partial recovery of hearing. The average hearing gain in the above-mentioned frequency range was 11 dB. In our patients the additional transtympanic application of corticoids did not result in a significantly improved recovery of hearing in comparison to the patients treated with the standard therapy alone.
Lautermann
Jürgen
J
Department of Otorhinolaryngology, St. Elisabeth-Hospital, University of Bochum, Bleichstr. 15, 44787 Bochum, Germany. j.lautermann@klinikum-bochum.de
Sudhoff
Holger
H
Junker
Rüdiger
R
D000208:Acute Disease; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D003639:Hearing Loss, Sudden / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage*; D014432:Tympanic Membrane
D005938:Glucocorticoids; D011239:Prednisolone; D008775:Methylprednisolone
HNO. 2001 Jul;49(7):538-42
11486587
Otol Neurotol. 2001 Jan;22(1):18-23
11314710
Am J Otol. 1998 Mar;19(2):196-201
9520056
Blood. 1995 Oct 15;86(8):3181-8
7579413
Acta Otolaryngol. 1993 May;113(3):303-6
7685975
Carcinogenesis. 1994 Sep;15(9):1807-13
7522979
Hear Res. 2001 May;155(1-2):9-20
11335072
J Neurol Sci. 1992 Aug;111(1):13-9
1402993
Laryngoscope. 1999 Jul;109(7 Pt 2):1-17
10399889
Laryngoscope. 2000 Nov;110(11):1902-6
11081607
Hepatology. 1999 Apr;29(4):1147-55
10094959
Acta Otolaryngol. 2002 Oct;122(7):698-702
12484644
AJNR Am J Neuroradiol. 1991 Jan-Feb;12(1):13-6
1899498
Laryngoscope. 1984 May;94(5 Pt 1):647-61
6325838
Arch Otolaryngol. 1980 Dec;106(12):772-6
7002129
Otol Neurotol. 2001 Jul;22(4):475-9
11449103
Otolaryngol Head Neck Surg. 1996 Jul;115(1):38-41
8758627
Ann Otol Rhinol Laryngol. 2000 Jan;109(1):30-2
10651408
Am J Otol. 1998 Mar;19(2):230-5
9520062