Intratympanic dexamethasone injection for refractory sudden sensorineural hearing loss.
OBJECTIVE
This case-control study aimed to analyze the effect of intratympanic dexamethasone injection (ITDI) as a treatment option for patients with sudden sensorineural hearing loss (SSNHL) who were refractory to classic oral steroid treatment.


METHODS
Sixty-six patients with SSNHL, who were refractory to a course of oral steroid therapy, were included in this study. We prospectively treated consecutive 33 patients (34 ears) with ITDI from August 2002 to January 2004. We then retrospectively collected data from age- and sex-matched previous patients who did not take any more treatments after the initial regimen between March 2000 and July 2002. ITDI was performed in the supine position on four separate occasions over the course of 2 weeks. Hearing was assessed immediately before every injection and at 1 week after therapy. Hearing improvement was defined as more than 10 dB in pure-tone average (PTA).


RESULTS
Hearing improvement was observed in 13 (39.4%) of 33 patients who underwent ITDI and in two (6.1%) of 33 patients in the control group. Five of 13 represented hearing improvement over than 20 dB in PTA, and 11 of 20 patients, who showed no improvement in PTA by ITDI, showed improvement over 10 dB in some frequencies. There were no definite prognostic factors between the patients who responded to ITDI and those who did not.


CONCLUSIONS
ITDI may be a simple and effective therapy for patients with refractory SSNHL.
Choung
Yun-Hoon
YH
Department of Otolaryngology, Ajou University School of Medicine, Suwon, South Korea. yhc@ajou.ac.kr
Park
Keehyun
K
Shin
You Ree
YR
Cho
Min Jung
MJ
D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001301:Audiometry, Pure-Tone / Q000379:methods; D016022:Case-Control Studies; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000187:drug effects*
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D003907:Dexamethasone