Efficacy of intratympanic steroid therapy for idiopathic sudden sensorineural hearing loss: comparison with systemic steroid therapy and combined therapy.
CONCLUSIONS
Intratympanic steroid therapy (IT-S) was as effective as systemic steroid therapy (SST) or combined therapy (CT) and could be considered a first-line therapeutic modality for idiopathic sudden sensorineural hearing loss (SSNHL). Due to its known safety and efficacy, IT-S will be particularly suitable for patients with SSNHL who have chronic diseases such as diabetes mellitus, hypertension, or chronic renal failure.


OBJECTIVE
Systemic high dose steroid therapy is the main therapeutic modality for SSNHL. Comparable therapeutic efficacies for IT-S and CT with SST and IT-S for SSNHL have been reported recently. We compared the efficacy of IT-S, SST, and CT for treating SSNHL.


METHODS
A retrospective, multicenter study investigating the therapeutic efficacy of SST, IT-S, and CT for SSNHL was designed and involved 735 patients with idiopathic SSNHL who were diagnosed and treated at seven tertiary referral medical centers of the Catholic University of Korea between 2007 and 2011. Patients were divided into three groups according to the treatment methods they received: IT-S group, SST group, and CT group (SS plus IT-S). Hearing was evaluated by pure tone audiogram performed before initial treatment and at 4 weeks following the final treatment. More than a 10 dB HL decrease in average air conduction threshold of hearing at 500, 1000, 2000, and 3000 Hz was defined as improved hearing.


RESULTS
Among 735 patients with SSNHL, 94 were included in the IT-S group, 444 in the SST, and 197 in the CT group. Age, gender, interval from disease onset to start of treatment, and initial hearing level were not different among the three groups. Patients who had concomitant medical disorders such as diabetes mellitus, hypertension, or chronic renal failure were more frequently treated with IT-S. No difference in the level of hearing gain or ratio of hearing improvement was observed among the three groups (p = 0.147 and p = 0.067, respectively).
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Catholic University of Korea, Seoul, Korea.
Seong-Cheon
SC
Bae
He-Il
HI
Noh
Beom-Cho
BC
Jun
Eun-Ju
EJ
Jeon
Jae-Hyun
JH
Seo
So-Young
SY
Park
Jun-Kyu
JK
Kim
Dong-Hee
DH
Lee
Jeong-Hoon
JH
Oh
Shi-Nae
SN
Park
Sang-Won
SW
Yeo
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000188:drug therapy*; D006801:Humans; D007322:Instillation, Drug; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane
D005938:Glucocorticoids; D003907:Dexamethasone; D011241:Prednisone