Intratympanic dexamethasone for refractory sudden sensorineural hearing loss

Abstract

Background: The standard medical regimen for SSNHL is systemic steroid therapy. Unfortunately, some patients either do not or poorly respond to systemic steroids. Intratympanic administration of steroids has been suggested as an alternative to systemic therapy. Objective: To determine if intratympanic dexamethasone injection (ITDI) is an effective treatment for sudden sensorineural hearing loss (SSNHL) in patients that systemic steroid treatment has failed. Material and Method: A prospective, non-randomized, controlled study evaluated the hearing outcomes in 14 SSNHL patients treated with ITDI as compared with the outcome of seven patients not treated. Int ratympanic dexamethasone was administered through a spinal needle under local anesthesia. ITDI was performed once every week for maximum of three sessions. Hearing was assessed immediately before the therapy and 4 weeks after the therapy. Results: Hearing improvement was documented in six of 14 patients (43%) who underwent ITDI compare to none of the seven patients (0%) in no ITDI group. However, this was not statistically significant (p = 0.055). Conclusion: Intratympanic dexamethasone (ITDI) may have benefits for patients with SSNHL who failed systemic steroid therapy.