title: Efficacy of intratympanic steroid administration on idiopathic sudden sensorineural hearing loss in comparison with hyperbaric oxygen therapy.
abstract: OBJECTIVE
  The efficacy of intratympanic steroid administration was examined in comparison with hyperbaric oxygen (HBO) therapy in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Two hundred seventy-six consecutive patients with ISSNHL (average hearing levels at 250, 500, 1,000, 2,000, and 4,000 Hz ≥ 40 dB; time from onset to treatment ≤30 days) were enrolled. All the patients were given intravenous hydrocortisone (400 mg/day) followed by tapered doses. In addition, 174 patients underwent HBO therapy (HBO group), and 102 patients received intratympanic dexamethasone injection (IT group). The hearing outcomes were evaluated by six indices; the cure rate, marked-recovery rate (percent of patients with hearing gains ≥30 dB), recovery rate (percent of patients with hearing gains ≥10 dB), hearing gain, hearing level after treatment, and hearing improvement rate compared to the unaffected contralateral ear.
  
  
  RESULTS
  There was no significant difference in the cure rate, marked-recovery rate, hearing gain, hearing level after treatment, or hearing improvement rate between the two groups; however, the recovery rate was significantly higher in the IT group than in the HBO group (79.4% vs. 68.4%; P = .048). Multiple logistic regression analysis also showed that patients in the IT group were significantly more likely to recover than those in the HBO group (odds ratio: 2.045; 95% confidence interval: 1.097-3.812; P = .024).
  
  
  CONCLUSIONS
  Systemic plus intratympanic steroid administration is more effective than systemic steroids plus HBO therapy, and can be a useful first-choice treatment for ISSNHL.
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. suzuhyde@med.uoeh-u.ac.jp
authors.forename: Hideaki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Koichi
authors.initials: K
authors.lastname: Hashida
authors.forename: Khac-Hung
authors.initials: KH
authors.lastname: Nguyen
authors.forename: Nobusuke
authors.initials: N
authors.lastname: Hohchi
authors.forename: Akiko
authors.initials: A
authors.lastname: Katoh
authors.forename: Hiroki
authors.initials: H
authors.lastname: Koizumi
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Ohbuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006309:Hearing / Q000187:drug effects / Q000502:physiology*; D006319:Hearing Loss, Sensorineural / Q000628:therapy; D003639:Hearing Loss, Sudden / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D007267:Injections; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone