Treatment of sensorineural hearing loss in acute viral otitis media with intratympanic dexamethasone and hyaluronic acid in comparison with intravenous therapy

• Published in: Laryngo- rhino- otologie Vol. 85; no. 1; p. 32
• Main Authors: Stenner, M, Jecker, P, Gouveris, H, Mann, W
• Format: Journal Article
• Language: German
• Published: Germany 01-01-2006
• Subjects: Acute Disease; Adjuvants, Immunologic - administration & dosage; Adult; Anti-Inflammatory Agents - administration & dosage; Audiometry; Bone Conduction; Data Interpretation, Statistical; Dexamethasone - administration & dosage; Drug Therapy, Combination; Ear, Middle; Female; Hearing Loss, Sensorineural - diagnosis; Hearing Loss, Sensorineural - drug therapy; Hearing Loss, Sensorineural - etiology; Humans; Hyaluronic Acid - administration & dosage; Hydroxyethyl Starch Derivatives - administration & dosage; Infusions, Intravenous; Injections; Male; Middle Aged; Otitis Media - complications; Otitis Media - drug therapy; Pentoxifylline - administration & dosage; Prednisolone - administration & dosage; Retrospective Studies; Vasodilator Agents - administration & dosage
• ISSN: 0935-8943
• DOI: 10.1055/s-2005-870274

Intratympanic dexamethasone with hyaluronic acid has shown to be an effective treatment of the inner ear damage in sudden hearing loss and Menière's disease. It is not known yet if the same applies to the toxic inner ear damage in acute viral otitis media.
Retrospectively, 26 patients who suffered from acute viral otitis media with sensorineural hearing loss were examined with regard to the improvement of their inner ear hearing loss. Twelve patients were treated with intravenous therapy only, consisting of hydroxyethyl starch, pentoxifylline and prednisolone. Fourteen patients additionally received intratympanic injections, consisting of dexamethasone and hyaluronic acid once acute inflammatory changes subsided. The inner ear hearing loss was evaluated by means of standard bone-conduction audiometry.
Neither local nor systemic side effects of the intratympanic injections occurred. During treatment no significant difference in the improvement of bone-conduction thresholds in any frequency was seen between the two groups.
Intratympanic injections of dexamethasone with hyaluronic acid do not result in any additional benefit on the sensorineural hearing loss in acute viral otitis media compared to intravenous therapy alone. A reason might be the post inflammatory changes of the round window membrane or the toxic nature of the acute viral infection affecting the inner ear.