title: Intratympanic steroid therapy for sudden hearing loss: a review of the literature.
abstract: OBJECTIVE
  Administration of steroids systematically is considered to be the most commonly accepted treatment for idiopathic sudden sensorineural hearing loss (ISSNHL). In recent years there has been increasing scientific interest in treating ISSNHL by means of local steroid delivery. Usually, intratympanic steroids are used in three main protocols, as initial treatment, as adjunctive treatment given concomitantly with systemic steroids and as salvage treatment after failure of standard therapy. The purpose of this review is to examine the published literature regarding the therapeutic value of each method of treatment and to seek answers about the best delivery technique and the optimal administration schedule.
  
  
  METHODS
  Literature review from 1996 to 2009, PubMed and Medline.
  
  
  METHODS
  We searched for trials concerning clinical evaluation of intratympanic steroids in ISSNHL patients, as a salvage treatment, as a first line therapy and in combination with the conventional therapy. Randomized and non-randomized case control studies and case series studies were the types of trials available for review.
  
  
  METHODS
  All the articles described in the study selection were used for this review.
  
  
  RESULTS
  Statistical techniques were not used.
  
  
  CONCLUSIONS
  On the basis of the available literature, it seems that topical steroids can be a valuable solution for ISSNHL patients who either cannot tolerate systemic steroid therapy or are refractory to it. Concerning the combined therapy, due to the controversial results of the existing studies, it cannot be determined yet whether this treatment protocol could yield superior results as a first line therapy. The need for establishment of standard criteria of hearing recovery should be underlined.
authors.affiliation: ENT Department, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Seggas
authors.forename: Petros
authors.initials: P
authors.lastname: Koltsidopoulos
authors.forename: Athanasios
authors.initials: A
authors.lastname: Bibas
authors.forename: Anastasia
authors.initials: A
authors.lastname: Tzonou
authors.forename: Aristides
authors.initials: A
authors.lastname: Sismanis
mesh_terms: D003907:Dexamethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D004333:Drug Administration Routes; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D003639:Hearing Loss, Sudden / Q000188:drug therapy*; D006801:Humans; D007267:Injections; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome; D014432:Tympanic Membrane
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D008775:Methylprednisolone