CC BY-NC-ND 4.0 · Laryngorhinootologie 2019; 98(S 02): S314
DOI: 10.1055/s-0039-1686396
Poster
Otology

The intratympanic application of corticoids in sudden hearing loss – a critical reflexion of this therapeutic option

V Helmstädter
1   HNO-Klinik der MHH, Hannover
,
W Roßberg
1   HNO-Klinik der MHH, Hannover
,
T Lenarz
1   HNO-Klinik der MHH, Hannover
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    Introduction:

    Therapy with intratympanic cortisone is part of the therapeutic regimen in sudden hearing loss regarding the German AWMF-guidelines. Meanwhile, this option is well established in most ENT-departments in Germany and many patients even demand this kind of therapy. Nevertheless, published clinical results are not overwhelmingly convincing so far. To evaluate the benefit of this therapy in our cohort we retrospectively analysed all 2018 cases which have been treated at our clinic.

    Methods:

    We use triamcinolone (40 mg/ml) injecting it in three consecutive weeks. It is performed in patients after unsuccessful systemic therapy as second-line therapy or in patients, who have contraindications to systemic cortisone as first-line therapy.

    Results:

    At abstract submission we had performed 74 treatments in 26 patients. Group A patients (22, 85%) had systemic therapy before, while four patients (15%, group B) experienced primary treatment. At this time point, 17 (65%) had returned for control pure tone audiometry. The pre-therapeutic four tone average (FTA; at 0.5, 1, 2 and 3 kHz) was 40 dB HL and the post-therapeutic FTA averaged at 37 dB HL. There was one significant improvement of more than 15 dB in group B and an improvement of more than 15 dB in 3 Group A patients. Control pure tone audiometry was performed on average 80 days after the last injection.

    Conclusion:

    Individual patients experienced hearing improvement, while the majority did not benefit from this therapy. Various factors like the pathogenesis of hearing loss and the kind and duration of prior therapies are among others relevant points influencing the outcome. Therefore, there seems to be only little evidence for the benefit of intratympanic cortisone.


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    Dr. med. Victor Helmstädter
    HNO-Klinik der MHH,
    Carl-Neuberg-Str. 1, 30625
    Hannover

    Publication History

    Publication Date:
    23 April 2019 (online)

    © 2019. The Author(s). 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/).

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