title: Simultaneous versus subsequent intratympanic dexamethasone for idiopathic sudden sensorineural hearing loss.
abstract: OBJECTIVE
  The authors compared the efficacy of simultaneous and subsequent intratympanic dexamethasone injections for the treatment of idiopathic sudden sensorineural hearing loss.
  
  
  METHODS
  Prospective randomized controlled multicenter study.
  
  
  METHODS
  Three tertiary university hospitals.
  
  
  METHODS
  In the simultaneous intratympanic dexamethasone group, intratympanic dexamethasone was given initially with systemic steroids. In the subsequent intratympanic dexamethasone group, intratympanic dexamethasone was given 7 days after systemic treatment. The authors compared hearing outcomes between the groups according to Siegel's criteria and frequency (0.25, 0.5, 1, 2, 3, 4, 6, and 8 kHz).
  
  
  RESULTS
  A total of 88 patients were analyzed in this study. There was no difference between the groups in hearing recovery according to Siegel's criteria or frequencies. Neither recovery time nor early recovery differed between the groups. In the subsequent intratympanic dexamethasone group, 15 patients showed hearing recovery within 7 days and did not need intratympanic dexamethasone treatment. After intratympanic dexamethasone treatment, >28% (25/88) of the patients complained of otalgia, transient dizziness, ear fullness, and headache. Five percent of the patients showed small, transient perforations and otorrhea during intratympanic dexamethasone treatment.
  
  
  CONCLUSIONS
  Simultaneous intratympanic dexamethasone did not confer an additional hearing gain or earlier recovery rate compared with subsequent intratympanic dexamethasone. A considerable number of patients did not need intratympanic dexamethasone for idiopathic sudden sensorineural hearing loss, and some patients experienced unnecessary side effects due to intratympanic dexamethasone. Therefore, the use of intratympanic dexamethasone is recommended only for subsequent or salvage treatment of idiopathic sudden sensorineural hearing loss after systemic steroid treatment.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Moo Kyun
authors.initials: MK
authors.lastname: Park
authors.forename: Chi Kyou
authors.initials: CK
authors.lastname: Lee
authors.forename: Kye Hoon
authors.initials: KH
authors.lastname: Park
authors.forename: Jong Dae
authors.initials: JD
authors.lastname: Lee
authors.forename: Chan Goo
authors.initials: CG
authors.lastname: Lee
authors.forename: Byung Don
authors.initials: BD
authors.lastname: Lee
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D007723:Korea; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone