title: Comparison of intratympanic and intravenous dexamethasone treatment on sudden sensorineural hearing loss with diabetes.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of intratympanic administration of dexamethasone (IT-DEX) treatment on sudden sensorineural hearing loss (SSNHL) patients with diabetes by comparing the results with intravenous administration of dexamethasone (IV-DEX) treatment.
  
  
  METHODS
  Comparative study.
  
  
  METHODS
  University hospital and affiliated hospital.
  
  
  METHODS
  Ten sequential SSNHL patients with diabetes receiving IT-DEX and 21 sequential SSNHL patients with diabetes receiving IV-DEX. Patients with low tone hearing loss were excluded.
  
  
  METHODS
  In the IT-DEX group, two methods were applied to deliver DEX (4 mg/ml): injection through a perforation made by laser-assisted myringotomy or through a tympanostomy tube. IT-DEX administration was performed on 8 sequential days. In the IV-DEX group, DEX was administrated intravenously starting from an amount of 8 mg/d followed by taped doses for 10 days.
  
  
  METHODS
  Preprocedure and postprocedure hearing levels and complications.
  
  
  RESULTS
  In the IT-DEX group, the average hearing level before the treatment was 79 dB. Overall, all 10 patients showed improvement of more than 10 dB in the pure-tone audiogram, with a mean improvement of 41 dB. Seven patients (70%) demonstrated successful results, and four recovered completely. In the IV-DEX group, 14 (67%) of the 21 patients showed improvement of more than 10 dB with a mean improvement of 25 dB. Thirteen patients (62%) demonstrated successful results. Free blood sugar during and after the IT-DEX treatment remained below the pretreatment levels, whereas four patients in the IV-DEX group demonstrated worsening of the hyperglycemia.
  
  
  CONCLUSIONS
  IT-DEX treatment is at least as effective as IV-DEX treatment for SSNHL patients with diabetes.
authors.affiliation: Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki, Japan. seijik@cc.hirosaki-u.ac.jp
authors.forename: Seiji
authors.initials: S
authors.lastname: Kakehata
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
authors.forename: Kasumi
authors.initials: K
authors.lastname: Oji
authors.forename: Kazunori
authors.initials: K
authors.lastname: Futai
authors.forename: Shuji
authors.initials: S
authors.lastname: Ota
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Makinae
authors.forename: Hideichi
authors.initials: H
authors.lastname: Shinkawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003907:Dexamethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D048909:Diabetes Complications / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D008876:Middle Ear Ventilation; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone