title: Intratympanic dexamethasone for refractory sudden sensorineural hearing loss.
abstract: BACKGROUND
  The standard medical regimen for SSNHL is systemic steroid therapy. Unfortunately, some patients either do not or poorly respond to systemic steroids. Intratympanic administration of steroids has been suggested as an alternative to systemic therapy.
  
  
  OBJECTIVE
  To determine if intratympanic dexamethasone injection (ITDI) is an effective treatment for sudden sensorineural hearing loss (SSNHL) in patients that systemic steroid treatment has failed.
  
  
  METHODS
  A prospective, non-randomized, controlled study evaluated the hearing outcomes in 14 SSNHL patients treated with ITDI as compared with the outcome of seven patients not treated. Intratympanic dexamethasone was administered through a spinal needle under local anesthesia. ITDI was performed once every week for maximum of three sessions. Hearing was assessed immediately before the therapy and 4 weeks after the therapy.
  
  
  RESULTS
  Hearing improvement was documented in six of 14 patients (43%) who underwent ITDI compare to none of the seven patients (0%) in no ITDI group. However, this was not statistically significant (p = 0.055).
  
  
  CONCLUSIONS
  Intratympanic dexamethasone (ITDI) may have benefits for patients with SSNHL who failed systemic steroid therapy.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand. niranhun@hotmail.com
authors.forename: Niran
authors.initials: N
authors.lastname: Hunchaisri
authors.forename: Suprapol
authors.initials: S
authors.lastname: Chantapant
authors.forename: Nongyouw
authors.initials: N
authors.lastname: Srinangyam
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D003907:Dexamethasone / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D011446:Prospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D011239:Prednisolone