title: The effect of intratympanic dexamethasone with oral prednisolone as a primary treatment in idiopathic sudden sensorineural hearing loss.
abstract: BACKGROUND
  Sudden sensorineural hearing loss (SSNHL) is a true emergency that must be diagnosed and treated immediately. The purpose of this study is to compare the efficacy of treatment with intratympanic dexamethasone plus oral prednisolone daily or every other day with that of treatment with oral prednisolone alone.
  
  
  METHODS
  Sixty-three patients with SSNHL that had been present for less than 10 days prior to the start of treatment were randomly allocated to three different groups. Patients in group A were treated daily with oral prednisolone 1 mg/kg for 10 days plus intratympanic dexamethasone 2 mg for the first 3 days of treatment. Patients in group B were treated every other day with oral prednisolone 1 mg/kg for 10 days with the addition of intratympanic dexamethasone 2 mg for the first 3 treatments. Patients in group C were treated daily with oral prednisolone 1 mg/kg alone for 10 days. Audiometric parameters including pure tone audiometry (PTA), speech reception threshold (SRT), and speech discrimination score (SDS) were assessed on days 1,5, and 10.
  
  
  RESULTS
  There was a significant improvement in PTA, SRT and SDS in each group over the 10 days but the greatest improvement was seen in the SRT measurements of group A in comparison with group B (19.81 ± 2.15, P=0.04) and C (26.26 ± 0.08, P=0.01). The difference in SRT between groups B and C was not statistically significant.
  
  
  CONCLUSIONS
  The administration of intratympanic dexamethasone 2 mg daily for 3 days has an additive effect to that of 10 days of oral prednisolone 1 mg/kg in the treatment of SSNHL.
authors.affiliation: Department of otorhinolaryngology, Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Khorsandi Ashtiani
authors.forename: Pedram
authors.initials: P
authors.lastname: Borgheie
authors.forename: Nasrin
authors.initials: N
authors.lastname: Yazdani
authors.forename: Shirin
authors.initials: S
authors.lastname: Maghsoud
keywords: Dexamethasone; Emergency; Oral; Otolaryngologic; Prednisolone; Pure tone audiometry; Sensorineural hearing loss; Speech discrimination test; Speech reception threshold test.