Therapeutic effectiveness over time of intratympanic dexamethasone as salvage treatment of sudden deafness.
CONCLUSIONS
Intratympanic dexamethasone (ITD) within 1 month after initial treatment failure should be utilized as salvage treatment for refractory sudden sensorineural hearing loss (SSNHL).


OBJECTIVE
To investigate the therapeutic efficacy over time of ITD as salvage treatment in SSNHL.


METHODS
We retrospectively reviewed the medical records and audiograms of 99 SSNHL patients who were refractory to 2 weeks of oral steroid treatment, from August 2003 to October 2006. Patients were divided into those receiving no further treatment (control group) and those receiving ITD within 2 weeks (early-ITD), between 2 weeks and 1 month (mid-ITD), and between 1 and 2 months (late-ITD) after initial treatment failure. ITD was performed in the supine position on four separate occasions over the course of 2 weeks. Final assessment of hearing was carried out 3 months after outbreak of SSNHL. Hearing improvement was defined as a > 15 dB decrease in four-tone average (FTA).


RESULTS
Overall hearing improvement was observed in 8 of 50 (16.0%) control patients, 7 of 16 (43.8%) early ITD patients, 6 of 20 (30.0%) mid ITD patients, and 2 of 13 (15.4%) late ITD patients.
Ahn
Joong Ho
JH
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. meniere@amc.seoul.kr
Han
Myung Woul
MW
Kim
Ji Heui
JH
Chung
Jong Woo
JW
Yoon
Tae Hyun
TH
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004432:Ear, Middle / Q000187:drug effects; D005260:Female; D003639:Hearing Loss, Sudden / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D008775:Methylprednisolone