Sudden sensorineural hearing loss (SNHL) means abrupt hearing loss by 30dB affecting three consecutive frequencies within 72 hours. This is treated by high tapering doses of systemic steroids, the role of which is controversial and fraught with possible complications in patients with diabetes and hypertension. The authors have elicited the role of intratympanic methylprednisolone in the treatment of SNHL as salvage treatment after the administration of high dose systemic steroids given for 7-10 days. Up to three intratympanic injections of methylprednisolone were given at weekly intervals. Remission in patients with non-functional hearing was defined as improvement to functional level (class A or B) and in patients with functional hearing, remission meant PTA reduction of 10dB or more and at least 20% improvement in speech discrimination score. Of the 128 patients, 57 had improved hearing after systemic steroids. From a total of 63 patients undergoing intratympanic treatment, 18 (28.6%) showed remission of hearing loss and 45 (71.4%) did not. Various characteristics of the ‘remission’ and the ‘non-remission’ groups were studied and it was noted that patients with vestibular symptoms and profound hearing loss had worse prognosis. Hearing improved more in the lower frequencies. The study is limited by lack of controls but opens avenues to more research such as comparison of intratympanic therapy with systemic therapy or both with no intratympanic therapy.
Adjuvant intratympanic steroid therapy in sudden sensorineural hearing loss
Top Of Page
Accreditations
Pinpoint Scotland Ltd (Registered in Scotland No. SC068684) | © 2024 - Website by Gecko Agency