Intratympanic methylprednisolone for sudden sensorineural hearing loss.

OBJECTIVE

Corticosteroids are commonly used for the treatment of sudden sensorineural hearing loss (SSHL). In this study, the effectiveness of intratympanic (IT) corticosteroid injection was studied and compared with a control group on patients with SSHL who failed systemic corticosteroid treatment.

MATERIALS AND METHODS

A total of 19 patients as a retreatment group (RG) and 18 patients as a control group (CG), all failed high-dose intravenous and oral corticosteroid treatments, were included in this study. These patients were invited back, and IT methylprednisolone was injected five times via 3-day intervals in RG and followed-up for a mean period of 24.9 months (range, 7-30 mo). Audiological evaluations were performed initially, a week after the completion of the injections, monthly in the following first 3 months, and at the end of follow-up period in RG. The CG was followed-up for 3 months after the completion of systemic corticosteroid treatment without any additional drug administration.

RESULTS

The mean age was 52.6 years (range, 20-79 yr) in RG and 59.9 years in CG. The mean pure-tone average for speech frequencies (500-4,000 Hz) at baseline audiogram and at the first month, at the third month, and at last controls were 65.2 (range, 43-102 dB), 45.4 (range, 23-77 dB), 43.6 (range, 30-77 dB), and 44.5 (range, 33-77 dB) dB, respectively, in RG. The mean pure-tone averages for speech frequencies (500-4,000 Hz) at the end of systemic treatment and at third-month control were 63.5 (range, 44-98 dB) and 59.0 (range, 40-100 dB) dB, respectively, in CG. The hearing gain that is equal to or more than 10 dB was achieved in 14 patients (73.6%) at the last control in RG. No hearing gain could be detected in the CG. No serious side effect was observed with IT treatment.

CONCLUSION

We conclude that IT methylprednisolone injection provides more significant hearing improvement for patients that failed with previous high-dose systemic corticosteroid administration than systemic corticosteroid treatment alone. So it may be the first-step medical treatment of idiopathic SSHL alone or at least may be combined with the systemic corticosteroid administration.