title: Successful continual intratympanic steroid injection therapy in a patient with refractory sensorineural hearing loss accompanied by relapsing polychondritis.
abstract: OBJECTIVE
  To report the treatment efficacy of continual intratympanic steroid injection (ITSI) therapy in a patient with refractory sensorineural hearing loss accompanied by relapsing polychondritis.
  
  
  METHODS
  A 49-year-old female diagnosed with relapsing polychondritis at the age of 45 years and who had been treated with corticosteroids and immunosuppressants developed sensorineural hearing loss in the left ear.
  
  
  METHODS
  Her unilateral hearing loss did not recover despite receiving one cyclophosphamide pulse treatment, one methylprednisolone pulse treatment, and weekly leukapheresis. Thus, we decided to initiate weekly ITSI therapy.
  
  
  METHODS
  Pure tone audiometry.
  
  
  RESULTS
  A week after the first ITSI treatment, the patient's hearing improved. We continued ITSI therapy and attempted to extend the interval between treatments, but her hearing worsened when ITSI therapy was delivered at 2- to 3-week intervals. Thus, we returned ITSI therapy to once per week for 21 months (total of 71 treatments). She experienced no adverse events, like tympanic perforation, and 1 year after terminating the therapy, her hearing remained stable and did not worsen.
  
  
  CONCLUSIONS
  Continual, weekly ITSI therapy was effective in treating sensorineural hearing loss accompanied by relapsing polychondritis. ITSI therapy may be a promising treatment option for sensorineural hearing loss caused by autoimmune disease.
authors.affiliation: Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan; Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan. Electronic address: wasano@a5.keio.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Wasano
authors.affiliation: Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Tomisato
authors.affiliation: Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Noriomi
authors.initials: N
authors.lastname: Suzuki
authors.affiliation: Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Kawasaki
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006319:Hearing Loss, Sensorineural / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D046088:Hearing Loss, Unilateral / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D000069555:Injection, Intratympanic; D008875:Middle Aged; D011081:Polychondritis, Relapsing / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; C004180:dexamethasone 21-phosphate; D003907:Dexamethasone
keywords: Autoimmune inner ear disease; Inner ear; Intratympanic steroid injection; Relapsing polychondritis