title: Early posttreatment audiometry underestimates hearing recovery after intratympanic steroid treatment of sudden sensorineural hearing loss.
abstract: Objective. To review our experience with intratympanic steroids (ITSs) for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL), emphasizing the ideal time to perform follow-up audiograms. Methods. Retrospective case review of patients diagnosed with ISSNHL treated with intratympanic methylprednisolone. Injections were repeated weekly with a total of 3 injections. Improvement was defined as an improved pure-tone average ≥20 dB or speech-discrimination score ≥20%. Results. Forty patients met the inclusion criteria with a recovery rate of 45% (18/40). A significantly increased response rate was found in patients having an audiogram >5 weeks after the first dose of ITS (9/13) over those tested ≤5 weeks after the first dose of ITS (9/27) (P = 0.03). Conclusions. Recovery from ISSNHL after ITS injections occurs more frequently >5 weeks after initiating ITS. This may be due to the natural history of sudden hearing loss or the prolonged effect of steroid in the inner ear.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, 3800 Reservoir Road, NW, Washington, DC 20007, USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Wycherly
authors.forename: Jared J
authors.initials: JJ
authors.lastname: Thompkins
authors.forename: H Jeffrey
authors.initials: HJ
authors.lastname: Kim