title: Intratympanic steroid injection as a first-line therapy in uremia patients with sudden sensorineural hearing loss.
abstract: CONCLUSIONS
  ITSI as a first-line therapy in uremia patients with SSNHL offers a valid and safe treatment compared with intravenous systemic steroid treatment. A specific pathophysiology caused by possible sodium pump paralysis may be explained for uremia patients with SSNHL.
  
  
  OBJECTIVE
  To compare the efficacy of intratympanic steroid injection (ITSI) with that of systemic intravenous steroids as a first-line therapy in uremia patients with sudden sensorineural hearing loss (SSNHL).
  
  
  METHODS
  A total of 23 consecutive uremia patients with SSNHL were enrolled in this study. Patients were divided into two groups: the ITSI group (n = 15) and the non-ITSI group (n = 8), in which patients received intravenous systemic steroid treatment. The two groups were homogeneous in all respects.
  
  
  RESULTS
  The hearing improvement and relative gain were statistically significant between the two groups. The value of hearing gain (ΔPTA = PTA pre - PTA post) in the ITSI group and the non-ITSI group was 24.6 ± 16.4dB and 8.4 ± 19.3dB. The value of relative gain (ΔPTA/PTApre) in the ITIS group and the non-ITSI group was 31.1 ± 22% and 9.4 ± 20.5%. In the ITSI group, 11 patients (73.3%) exhibited hearing recovery (ΔPTA > 10 dB).
authors.affiliation: Department of Otolaryngology, Mackay Memorial Hospital , Taipei , Taiwan.
authors.forename: Hsun-Tien
authors.initials: HT
authors.lastname: Tsai
authors.forename: Naiwei
authors.initials: N
authors.lastname: Hsueh
authors.forename: Chih-Ming
authors.initials: CM
authors.lastname: Huang
authors.forename: Hung-Ching
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000368:Aged; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006309:Hearing / Q000502:physiology*; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D003639:Hearing Loss, Sudden / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D000069555:Injection, Intratympanic; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014511:Uremia / Q000150:complications* / Q000188:drug therapy
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone
keywords: intratympanic steroid; sodium pump; sudden deafness therapy; sudden hearing loss; uremia; vertigo