Intratympanic methylprednisolone improves hearing function in refractory sudden sensorineural hearing loss: a control study.
OBJECTIVE
The aim of this study was to describe our experience with intratympanic (IT) steroid treatment of sudden sensorineural hearing loss (SSNHL) after the failure of intravenous (IV) steroid treatment and to examine the efficacy of this treatment.


METHODS
We recruited 65 patients with SSNHL who did not respond to IV treatment with prednisolone. These patients were randomized into 3 groups: treatment with IT steroid, treatment with steroid in ear drops, and blank control. The 24 patients in the IT group received an IT injection of methylprednisolone and the 21 patients in the ear drop group received methylprednisolone that was directly dropped onto the tympanic membrane through the ear canal. The 20 patients in the blank control group did not receive any treatment after the completion of the IV prednisolone injection. Audiograms were performed at the beginning of the study and 2 months after the end of the study.


RESULTS
In the IT treatment group, audiogram results showed that the average of the pure tone speech frequencies (500-4000 Hz) was 64.8 (range 40-101 dB) at baseline, 60.7 (range 35-92 dB) at the end of systemic treatment, and 52.9 (range 35-73 dB) at the end of IT treatment. The improvement in the IT group was significantly better than that in the other two groups, with 37% of the IT patients having significant improvement in their hearing (baseline to after systemic treatment). During IT treatment, only 1 patient developed a persistent tympanic membrane perforation, and no serious complications such as chronic otitis media, disequilibrium, and dysgeusia developed.


CONCLUSIONS
IT steroid therapy can improve hearing function in patients with SSNHL after the failure of systemic steroid treatment.
Department of Otolaryngology - Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, PR China. lp76@163.net
Peng
P
Li
Xiang-L
XL
Zeng
Jin
J
Ye
Qin-T
QT
Yang
Ge-H
GH
Zhang
Yuan
Y
Li
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; 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; D007267:Injections; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome; D014432:Tympanic Membrane
D005938:Glucocorticoids; D008775:Methylprednisolone