title: Intratympanic steroid injections as a salvage treatment for sudden sensorineural hearing loss: a randomized, double-blind, placebo-controlled study.
abstract: OBJECTIVE
  The purpose of this study was to determine, through a randomized, double-blind, placebo-controlled trial, whether intratympanic steroid injections (ITSIs) could improve hearing recovery in patients with sudden sensorineural hearing loss (SSHL) who did not respond to initial systemic steroid therapy.
  
  
  METHODS
  This was a prospective, randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  The study was conducted in 2 tertiary referral centers.
  
  
  METHODS
  A total of 60 patients with idiopathic SSHL who did not respond to an initial round of systemic steroid therapy were included in this study. The subjects were randomized into an ITSI group and an intratympanic normal saline injection (ITNI) group, which were matched by age and sex. A total of 55 subjects completed the study.
  
  
  METHODS
  Participants received either ITSIs or ITNIs. Both groups received 4 injections within a 2-week period.
  
  
  METHODS
  Pure-tone thresholds were compared between the 2 groups 1 month after injection therapy.
  
  
  RESULTS
  In the ITNI group, the pure-tone threshold was 69.9 ± 18.5 dB before intratympanic injection therapy. After therapy, the hearing threshold improved by an average of 4.5 ± 6.5 dB, and 10.7% of subjects improved by 10 dB or more. In the ITSI group, the pure-tone threshold was 64.6 ± 17.7 dB before intratympanic injection therapy. After the therapy, the hearing threshold improved by an average of 9.8 ± 8.5 dB, and 44.4% of subjects improved by 10 dB or more. Both the response rate and the level of hearing improvement were significantly greater in the ITSI group than in the ITNI group.
  
  
  CONCLUSIONS
  These results demonstrate that ITSIs are beneficial as a salvage therapy for the treatment of patients with idiopathic SSHL who fail to respond to initial systemic steroid therapy.
authors.affiliation: Department of Otolaryngology, Buddhist Tzuchi General Hospital, Taichung Branch, Taichung, Taiwan, Republic of China.
authors.forename: Hung-Pin
authors.initials: HP
authors.lastname: Wu
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Chou
authors.forename: Szu-Hui
authors.initials: SH
authors.lastname: Yu
authors.forename: Cheng-Ping
authors.initials: CP
authors.lastname: Wang
authors.forename: Chuan-Jen
authors.initials: CJ
authors.lastname: Hsu
authors.forename: Peir-Rong
authors.initials: PR
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000187:drug effects*; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; 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; D008875:Middle Aged; D011446:Prospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome; D014432:Tympanic Membrane
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone