title: Effects of early intratympanic steroid injection in patients with acoustic trauma caused by gunshot noise.
abstract: CONCLUSIONS
  This study evaluated the efficacy of concurrent administration of ITSI and systemic steroids in delayed treatment of NIHL after gunshot noise exposure. The results showed additional hearing benefits with administration of ITSI. Further evaluation is warranted to confirm this efficacy.
  
  
  OBJECTIVE
  This investigation evaluated the effects of early administration of an intratympanic steroid injection (ITSI) in combination with systemic steroids treatment in patients with acoustic trauma caused by gunshot noise.
  
  
  METHODS
  Nineteen patients eligible under the criteria established concerning delayed treatment for noise-induced hearing loss (NIHL) were enrolled in this study. Patients were divided into two groups: those who received prednisolone (PD) only (n = 8), and those who received PD with ITSI (n = 11). ITSI treatment was initiated simultaneously alongside systemic PD administration. These patients received ITSI every other day for a total of four treatments. Pure-tone air conduction threshold audiometry, to record the pure-tone average (PTA) at 2, 4, and 8 kHz, was conducted upon each patient's initial visit, and 1 month after starting treatment, to evaluate the degree of hearing gain (hearing gain (dB) = (initial PTA) - (final PTA)).
  
  
  RESULTS
  The initial PTA in PD-only and PD with ITSI groups were 52.75 ± 15.50 dB and 50.27 ± 12.01 dB, respectively. There were no significant differences in the baseline characteristics of the two groups, which include age and the number of days that treatment was delayed. In the multivariable linear regression analysis, both the initial PTA and the treatment method showed a significant association (R2=0.41). The unstandardized regression coefficient of the initial PTA was 0.47 (p = 0.02). Patients with additional ITSI showed significant improvement in the degree of hearing gain compared with the PD-only group (unstandardized regression coefficient =11.48, p = 0.03).
authors.affiliation: a Department of Otorhinolaryngology , ROK Armed Forces Yangju Hospital , Yangju , Republic of Korea.
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Chang
authors.affiliation: a Department of Otorhinolaryngology , ROK Armed Forces Yangju Hospital , Yangju , Republic of Korea.
authors.forename: Kang Hyun
authors.initials: KH
authors.lastname: Bang
authors.affiliation: a Department of Otorhinolaryngology , ROK Armed Forces Yangju Hospital , Yangju , Republic of Korea.
authors.forename: Byoungseo
authors.initials: B
authors.lastname: Jeong
authors.affiliation: a Department of Otorhinolaryngology , ROK Armed Forces Yangju Hospital , Yangju , Republic of Korea.
authors.forename: Gang-Gyu
authors.initials: GG
authors.lastname: Lee
mesh_terms: D000328:Adult; D020441:Ginkgo biloba; D005938:Glucocorticoids / Q000008:administration & dosage*; D006317:Hearing Loss, Noise-Induced / Q000188:drug therapy*; D006801:Humans; D000069555:Injection, Intratympanic; D008297:Male; D008889:Military Personnel; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use; D011239:Prednisolone / Q000008:administration & dosage*; D055815:Young Adult; D000096983:Ginkgo Extract
chemical_list: D005938:Glucocorticoids; D010936:Plant Extracts; D011239:Prednisolone; C063170:Ginkgo biloba extract; D000096983:Ginkgo Extract
keywords: Noise induced hearing loss; gunshot noise; hearing gain; intratympanic steroid injection