title: Intratympanic dexamethasone/hyaluronic acid mix as an adjunct to intravenous steroid and vasoactive treatment in patients with severe idiopathic sudden sensorineural hearing loss.
abstract: OBJECTIVE
  To evaluate differences in effectiveness (hearing recovery rates) between idiopathic sudden sensorineural hearing loss (ISSNHL) patients treated with intravenous therapy alone and patients treated with a combination of intravenous and intratympanic therapy.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Tertiary referral hospital center.
  
  
  METHODS
  Ninety-four patients with moderate ISSNHL treated with an intravenous steroid and vasoactive regimen (duration of therapy, 9 ± 2.76 d) and 76 patients with severe ISSNHL treated with a combination regimen of intravenous and intratympanic therapy (duration of therapy, 10 ± 2.71 d) were reviewed. In the latter patients' group, a series of 3 intratympanic injections of a dexamethasone/hyaluronic acid mix solution were applied every 2 days.
  
  
  METHODS
  Pure-tone audiometric thresholds at 0.5, 1, 2, 4, and 8 kHz were compared between groups using the Wilcoxon test.
  
  
  RESULTS
  Combination therapy in severe ISSNHL did not show any statistically significant difference in effectiveness to intravenous therapy in moderate ISSNHL (p > 0.05).
  
  
  CONCLUSIONS
  In patients with severe ISSNHL, starting intratympanic steroid therapy as an adjunct early in the course of intravenous steroid and vasoactive therapy improves hearing to a level which is obtained in patients with less severe (moderate) ISSNHL treated with intravenous therapy alone.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The University of Mainz Hospital and Clinics, Mainz, Germany. hagouve@yahoo.de
authors.forename: Haralampos
authors.initials: H
authors.lastname: Gouveris
authors.forename: Wiebke
authors.initials: W
authors.lastname: Schuler-Schmidt
authors.forename: Torsten
authors.initials: T
authors.lastname: Mewes
authors.forename: Wolf
authors.initials: W
authors.lastname: Mann
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; 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; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D007267:Injections; D007275:Injections, Intravenous; D008297:Male; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014432:Tympanic Membrane
chemical_list: D005938:Glucocorticoids; D013256:Steroids; D003907:Dexamethasone; D006820:Hyaluronic Acid