The authors have no funding, financial relationships, or conflicts of interest to disclose.
Comparison of intermittent intratympanic steroid injection and near-continual transtympanic steroid perfusion as salvage treatments for sudden sensorineural hearing loss
Version of Record online: 26 JUN 2013
Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 123, Issue 9, pages 2264–2269, September 2013
How to Cite
Chou, Y.-F., Chen, P.-R., Kuo, I.-J., Yu, S.-H., Wen, Y.-H. and Wu, H.-P. (2013), Comparison of intermittent intratympanic steroid injection and near-continual transtympanic steroid perfusion as salvage treatments for sudden sensorineural hearing loss. The Laryngoscope, 123: 2264–2269. doi: 10.1002/lary.23909
- Issue online: 23 AUG 2013
- Version of Record online: 26 JUN 2013
- Manuscript Accepted: 31 OCT 2012
- Idiopathic sudden sensorineural hearing loss;
- transtympanic steroid perfusion;
- intratympanic injection;
- Silverstein MicroWick;
- salvage therapy
The purpose of this study was to investigate whether near-continual transtympanic steroid perfusion is more effective than intermittent intratympanic steroid injection as a salvage therapy for idiopathic sudden sensorineural hearing loss.
Case control study.
We designed a case-control study consisting of 60 patients with sudden sensorineural hearing loss who did not respond well to systemic steroid therapy. From November 2008 to October 2010, we prospectively enrolled subjects for the transtympanic steroid perfusion therapy. We retrospectively collected data from age- and sex-matched patients who had undergone intratympanic steroid injection between January 2003 and October 2008. The audiological results of the two groups were compared.
The presalvage pure tone threshold was 65.4 ± 13.5 dB in the transtympanic steroid perfusion group. After the therapy, the hearing threshold was improved by an average of 15.0 ± 9.7 dB, and 53.3% of subjects had improved by 10 dB or more. The speech discrimination score was improved from 12.6% ± 7.0% to 54.4 ± 6.4%. In the intratympanic steroid injection group, the presalvage pure tone threshold was 68.8 ± 16.0 dB. After the therapy, the hearing threshold was improved by an average of 10.7 ± 9.8 dB, and 43.3% of subjects had improved by 10 dB or more. The speech discrimination score was improved from 13.3 ± 6.0% to 46.4 ± 12%. The degree of hearing improvement was significantly greater in the transtympanic group.
Both transtympanic steroid perfusion and intratympanic steroid injection can be used as salvage therapies for idiopathic sudden sensorineural hearing loss. Near-continual transtympanic steroid perfusions may provide better audiological results.
Level of Evidence: 3b. Laryngoscope, 123:2264–2269, 2013