Intratympanic Steroid for the Management of Sudden Hearing Loss: Introduction of a Tapering Method

• Published in: Iranian journal of otorhinolaryngology Vol. 34; no. 120; pp. 9 - 16
• Main Authors: Rajati, Mohsen, Ghasemi, Mohammad Mehdi, Sharifian, Mohammad-Reza, Nourizadeh, Navid, Yousefi, Razieh, Hosseinpoor, Masoumeh
• Format: Journal Article
• Language: English
• Published: Iran Mashhad University of Medical Sciences 01-01-2022
• Subjects: intratympanic; Original; steroid; sudden sensorineural hearing loss; Steroid; Sudden sensorineural hearing loss; Intratympanic
• ISSN: 2251-7251; 2251-726X
• DOI: 10.22038/IJORL.2021.57477.2977

Sudden sensorineural hearing loss (SSNHL) is a therapeutic challenge. There are several controversies regarding the management protocol of SSNHL. This study aimed to present the results of a novel treatment algorithm, which is a combination of systemic steroids and a tapering intratympanic (IT) dexamethasone regimen.
The past 10 years' medical records of idiopathic SSNHL cases in Ghaem and Emamreza hospital, Mashhad University of Medical Sciences were evaluated. Patients were assessed using standardized methods for pure-tone threshold audiometry. The management method of SSNHL treatment included oral steroids combined with IT administration of dexamethasone once a day for 7 days and continuing it on an alternate day and then weekly basis. Patients' recovery was assessed using Siegel's criteria.
This study included a total of 248 cases of idiopathic sudden hearing loss, with a mean age of 40.63±16.19 years. In total, 105 (42.3%) and 143 (57.7%) patients were female and male, respectively. The most common associated symptoms included tinnitus (86.9%, n=205) followed by vertigo (52.1%, n=122). The final hearing outcome of patients showed that 39 (15.7%), 38(15.3%), 86 (34.7%), and 85 (34.3%) patients underwent a complete recovery, partial recovery, slight recovery, and no recovery, based on Siegel's criteria.
The dose, interval, and duration of IT steroid treatment were not universally approved. The treatment method designed based on a tapering of IT steroid injection in combination with already known systemic administration of steroids can be a treatment option in SSNHL patients.