Efficacy of multimodality approach to sudden hearing loss.
OBJECTIVE
This study aims to investigate whether addition of intratympanic steroid (ITS) to systemic steroid and hyperbaric oxygen (HBO) is effective in the treatment of sudden hearing loss (SHL).


METHODS
Between January 2008 and October 2011, 58 patients diagnosed with SHL were enrolled in the study. Twenty patients (11 males, 9 females; mean age 45.3±21 years; range 24 to 66 years) who received systemic steroid and HBO composed group 1, while 38 patients (19 males, 19 females; mean age 41.6±16 years; range 25 to 61 years) who received ITS in addition to systemic steroid and HBO composed group 2.


RESULTS
Post-treatment hearing improvement was statistically significant in both groups in terms of the mean pure tone according to the Siegel's criteria (p<0.05). Treatment was successful at 55% of patients in group 1 and 63% in group 2. Despite increased success rate with the addition of ITS, it did not indicate statistical significance (p>0.05). However, there was a strong statistically significant difference in terms of profound hearing loss over 90 dB (p<0.05). None of six patients (0%) with profound hearing loss in group 1 benefited treatment, while addition of ITS to the treatment yielded success in six of 12 patients with profound hearing loss (50%) in group 2 (p<0.05).


CONCLUSIONS
Addition of ITS to systemic steroid and HBO treatment may yield better results in patients with SHL. However, ITS injection seems beneficial for patients with profound SHL.
Department of Otolaryngology, Haydarpaşa Numune Training Hospital, 34668 Üsküdar, İstanbul, Turkey.
Bariş
B
Naiboğllu
Semra
S
Külekçi
Mehmet
M
Sürmeli
Ayşegül
A
Verim
Çiğdem
Ç
Kalaycik Ertugay
Önder
Ö
İhvan
Lütfü
L
Şeneldir
Sema
S
Zer Toros
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006309:Hearing / Q000502:physiology*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D000069555:Injection, Intratympanic; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D005938:Glucocorticoids; D003907:Dexamethasone