Download PDF
CC BY-NC-ND 4.0 · Annals of Otology and Neurotology 2019; 2(02): 59-65
DOI: 10.1055/s-0039-1695677
Original Article

Steroid Therapy in the Management of Sudden Sensorineural Hearing Loss: A Nonrandomized Clinical Trial

Gowri Swaminathan 
1   Department of Otology, KKR ENT Hospital and Research Institute, Chennai, Tamil Nadu, India
,
Ravi Ramalingam
1   Department of Otology, KKR ENT Hospital and Research Institute, Chennai, Tamil Nadu, India
,
Ramalingam Kombupalayam Kumarappa Gounder
1   Department of Otology, KKR ENT Hospital and Research Institute, Chennai, Tamil Nadu, India
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective The aim of this study was to compare the effectiveness of intratympanic (IT) steroid therapy and combined intravenous-cum-intratympanic (IVIT) steroid therapy in the management of sudden sensorineural hearing loss (SSNHL).

Study Design This was a nonrandomized clinical trial.

Setting Tertiary referral center.

Patients Forty-four patients, who presented to the outpatient department or the emergency room and those who fulfilled the inclusion criteria, were enrolled in this study. The patients were put into two groups: Group IT—that received intratympanic steroid therapy alone and Group IVIT—that received intratympanic as well as intravenous steroid therapies.

Intervention Therapeutic—in the form of IVIT steroid therapy.

Main Outcome Measure Impact of the steroid therapy in patients with SSNHL was measured objectively with the help of pure tone audiometry (PTA). The improvement in hearing was assessed in terms of decibels gained after the intervention in both the groups.

Results The mean improvement in PTA after 3 months in Group IT was 19.78 (±18.918) dB, whereas the mean improvement after 3 months in Group IVIT was 22.29 (±16.147) dB, statistically showing no significant difference between the groups.

Conclusion The authors recommend the use of IT steroid therapy alone in the management of SSNHL.

Keywords

hearing loss - intratympanic steroids - sudden sensorineural hearing loss


Publication History

Article published online:
09 September 2019

© 2019. Indian Society of Otology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Vijayendra H, Buggaveeti G, Parikh B, Sangitha R. Sudden sensorineural hearing loss: an otologic emergency. Indian J. Otolaryngol Head Neck Surg 2012; 64 (01) 1-4
    Google Scholar
  • 2 Kleyn AD. Sudden complete or partial loss of function of the octavus-system in apparently normal persons. Acta Otolaryngol 1944; 32 (5–6) 407-429
    CrossrefGoogle Scholar
  • 3 Wilson WR, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol 1980; 106 (12) 772-776
    CrossrefPubMedGoogle Scholar
  • 4 Schuknecht HF, Donovan ED. The pathology of idiopathic sudden sensorineural hearing loss. Arch Otorhinolaryngol 1986; 243 (01) 1-15
    CrossrefPubMedGoogle Scholar
  • 5 Byl Jr FM. Sudden hearing loss: eight years’ experience and suggested prognostic table. Laryngoscope 1984; 94 (5 Pt 1) 647-661
    CrossrefPubMedGoogle Scholar
  • 6 Quinn FB, Ryan MW, Kharodwala M, Makishima T. Sudden Sensorineural Hearing Loss and Intratympanic Steroids. Paper presented at: Grand Rounds Presentation, UTMB, Dept. Of Otolaryngology. June 14 2006
    Google Scholar
  • 7 Koltsidopoulos P, Bibas A, Sismanis A, Tzonou A, Seggas I. Intratympanic and systemic steroids for sudden hearing loss. Otol Neurotol 2013; 34 (04) 771-776
    CrossrefPubMedGoogle Scholar
  • 8 Van Wijck F, Staecker H, Lefebvre PP. Topical steroid therapy using the Silverstein Microwick in sudden sensorineural hearing loss after failure of conventional treatment. Acta Otolaryngol 2007; 127 (10) 1012-1017
    CrossrefPubMedGoogle Scholar
  • 9 Patrikar SR. Hypothesis testing: the difference between two population means. In: Bhalwar R. ed. Text Book of Public Health and Community Medicine. Department of Community Medicine. Pune, India: Armed Forces Medical College, Pune in collaboration with World Health Organization India office; 2009: 243
    Google Scholar
  • 10 Patrikar SR. Which statistical procedures to use depending upon exposure and outcome variable?. In: Bhalwar R. ed. Text Book of Public Health and Community Medicine. Department of Community Medicine. Pune, India: Armed Forces Medical College, Pune in collaboration with World Health Organization, India office; 2009: 274
    Google Scholar
  • 11 Ferri E, Frisina A, Fasson A.C, Armato E, Spinato G, Amadori M.. Intratympanic steroid treatment for idiopathic sudden sensorineural hearing loss after failure of intravenous therapy. ISRN Otolaryngol 2012; 2012: 64271
    CrossrefGoogle Scholar
  • 12 Lin SW, Lin YS, Weng SF, Chou CW. Risk of developing sudden sensorineural hearing loss in diabetic patients: a population-based cohort study. Otol Neurotol 2012; 33 (09) 1482-1488
    CrossrefPubMedGoogle Scholar
  • 13 Massachusetts Eye and Ear. [Online]. Available at: http://www.masseyeandear.org/for-patients/patient-guide/patient-education/diseases-and-conditions/sudden-deafness/. Accessed April 11, 2017
  • 14 Gianoli GJ, Li JC. Transtympanic steroids for treatment of sudden hearing loss. Otolaryngol Head Neck Surg 2001; 125 (03) 142-146
    CrossrefPubMedGoogle Scholar
  • 15 Rauch SD, Halpin CF, Antonelli PJ. et al. Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: a randomized trial. JAMA 2011; 305 (20) 2071-2079
    CrossrefPubMedGoogle Scholar
  • 16 Arastou S, Tajedini A, Borghei P. Combined intratympanic and systemic steroid therapy for poor-prognosis sudden sensorineural hearing loss. Iran J Otorhinolaryngol 2013; 25 (70) 23-28
    PubMedGoogle Scholar
  • 17 Heman-Ackah SE, Jabbour N, Huang TC. Asymmetric sudden sensorineural hearing loss: is all this testing necessary?. J Otolaryngol Head Neck Surg 2010; 39 (05) 486-490
    Google Scholar
  • 18 Chandrasekhar SS, Saunders JE. 2008 and 2011). Sudden Sensorineural Hearing Loss: An Otologic Emergency? AAO-HNSF AcademyU® online classroom.
  • 19 Stachler RJ, Chandrasekhar SS, Archer SM. et al. American Academy of Otolaryngology-Head and Neck Surgery. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012; 146 (Suppl. 03) S1-S35
    CrossrefPubMedGoogle Scholar
  • 20 Kim YH, Park KT, Choi BY. et al. Early combination treatment with intratympanic steroid injection in severe to profound sudden sensorineural hearing loss improves speech discrimination performance. Eur Arch Otorhinolaryngol 2012; 269 (10) 2173-2178
    CrossrefPubMedGoogle Scholar
  • 21 Stokroos RJ, Albers FW, Schirm J. The etiology of idiopathic sudden sensorineural hearing loss. Experimental herpes simplex virus infection of the inner ear. Am J Otol 1998; 19 (04) 447-452
    Google Scholar
  • 22 Lamm K, Arnold W. The effect of prednisolone and non-steroidal anti-inflammatory agents on the normal and noise-damaged guinea pig inner ear. Hear Res 1998; 115 (1-2) 149-161
    CrossrefPubMedGoogle Scholar
  • 23 Rarey KE, Luttge WG. Presence of type I and type II/IB receptors for adrenocorticosteroid hormones in the inner ear. Hear Res 1989; 41 (2-3) 217-221
    CrossrefPubMedGoogle Scholar
  • 24 Yilmaz I, Yilmazer C, Erkan AN, Aslan SG, Ozluoglu LN. Intratympanic dexamethasone injection effects on transient-evoked otoacoustic emission. Am J Otolaryngol 2005; 26 (02) 113-117
    CrossrefPubMedGoogle Scholar
  • 25 Kopke RD, Hoffer ME, Wester D, O’Leary MJ, Jackson RL. Targeted topical steroid therapy in sudden sensorineural hearing loss. Otol Neurotol 2001; 22 (04) 475-479
    CrossrefPubMedGoogle Scholar
  • 26 Hunchaisri N, Chantapant S, Srinangyam N. Intratympanic dexamethasone for refractory sudden sensorineural hearing loss. J Med Assoc Thai 2010; 93 (12) 1406-1414
    PubMedGoogle Scholar