Clinical efficacy of initial intratympanic steroid treatment on sudden sensorineural hearing loss with diabetes.
OBJECTIVE
The purpose of this study is to compare the efficacy of intratympanic steroid injection (ITSI) with that of systemic steroids as an initial treatment of sudden sensorineural hearing loss (SNHL) with diabetes.


METHODS
Prospective, nonrandomized multicenter clinical trial.


METHODS
Multicenter study in Busan and Masan, South Korea.


METHODS
A total of 114 sudden SNHL patients who were diagnosed with diabetes were divided into peroral (PO) group (n = 48), intravenous (IV) group (n = 32), and intratympanic (IT) group (n = 34). In the PO group, prednisolone was used orally for 10 days, per schedule. In the IV group, prednisolone was administered intravenously for seven days, followed by oral administration of tapered doses for another several days. In the IT group, dexamethasone was injected into the tympanic cavity four times within a two-week period. Hearing outcome was assessed before and after the treatment.


RESULTS
All groups showed significant improvement with criteria of 15 dB (P < 0.05). However, there was no significant difference in hearing gain and recovery rate among groups (P > 0.05). Systemic steroid treatment was stopped for two patients in the IV group and for one in the PO group due to uncontrolled hyperglycemia. However, in the IT group, there were no patients who failed to control their blood sugar level.


CONCLUSIONS
ITSI is as effective as systemic steroid treatment for sudden SNHL patients with diabetes and it can avoid undesirable side effects. Therefore, we consider ITSI to be a more reasonable alternative as an initial treatment for sudden SNHL patients with diabetes.
Department of Otorhinolaryngology, Wallace Memorial Baptist Hospital, Geum-Jung Gu, Busan, Korea.
Chi-Sung
CS
Han
Jong-Ryul
JR
Park
Sung-Hyun
SH
Boo
Joon-Man
JM
Jo
Kyung-Won
KW
Park
Won-Yong
WY
Lee
Joong-Gi
JG
Ahn
Myung-Koo
MK
Kang
Byung-Gun
BG
Park
Hyun
H
Lee
D000284:Administration, Oral; D000287:Administration, Topical; D003907:Dexamethasone / Q000008:administration & dosage; D003925:Diabetic Angiopathies / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D011446:Prospective Studies; D013256:Steroids / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D003907:Dexamethasone; D006442:Glycated Hemoglobin; D011239:Prednisolone; D013256:Steroids