This study was supported by a grant from the National Research Foundation of Korea (Project number 2012R1A1A2004323). The authors have no funding, financial relationships, or conflicts of interest to disclose.
Round window membrane vibration may increase the effect of intratympanic dexamethasone injection
Article first published online: 9 DEC 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 6, pages 1444–1451, June 2014
How to Cite
Park, S. H. and Moon, I. S. (2014), Round window membrane vibration may increase the effect of intratympanic dexamethasone injection. The Laryngoscope, 124: 1444–1451. doi: 10.1002/lary.24482
- Issue published online: 27 MAY 2014
- Article first published online: 9 DEC 2013
- Accepted manuscript online: 23 OCT 2013 10:23PM EST
- Manuscript Accepted: 18 OCT 2013
- Manuscript Revised: 27 AUG 2013
- Manuscript Received: 21 APR 2013
- Round window;
- sudden hearing loss
We investigated whether the round window membrane (RWM) vibration can facilitate dexamethasone perfusion via the RWM in patients with sudden hearing loss.
We first performed an in vitro study using a semipermeable membrane. In the subsequent in vivo study, 20 mice were randomized into two groups: an intratympanic dexamethasone injection (ITDI)-only group, and an ITDI with RWM vibration group. Concentration of dexamethasone was investigated using high performance liquid chromatography. Third, we performed a prospective clinical study. Fifty-five refractory sudden hearing loss patients were divided into two groups: those who received ITDI only (n = 36) and those who received ITDI with RWM vibration (n = 19). Final hearing assessments were conducted 2 months after salvage treatment.
In the in vitro study, the concentration of dexamethasone increased with vibration time with the peak concentration observed at 3 minutes of vibration. In the in vivo study, ITDI with RWM vibration resulted in a significantly higher perilymph concentration of dexamethasone (7.68 ± 3.13 µg/ml) than that in the ITDI-only group (2.66 ± 1.73 µg/ml). In a clinical setting, the overall improvement in hearing was similar between the two groups. However, when we compared the speech discrimination score between the two groups, we found that the relative discrimination gain in the ITDI with RWM vibration group (18.11 ± 23.54%) was higher than that in the ITDI-only group (7.00 ± 15.54%) (P = 0.042).
RWM vibration can enhance the effect of intratympanic dexamethasone injection and is a viable treatment option for sudden hearing loss.
Levels of Evidence
N/A. Laryngoscope, 124:1444–1451, 2014