Effectiveness of Intratympanic Dexamethasone Injection in Sudden-Deafness Patients as Salvage Treatment
Article first published online: 3 JAN 2009
Copyright © 2004 The Triological Society
Volume 114, Issue 7, pages 1184–1189, July 2004
How to Cite
Guan-Min, H., Hung-Ching, L., Min-Tsan, S., Cheng-Chien, Y. and Hsun-Tien, T. (2004), Effectiveness of Intratympanic Dexamethasone Injection in Sudden-Deafness Patients as Salvage Treatment. The Laryngoscope, 114: 1184–1189. doi: 10.1097/00005537-200407000-00010
- Issue published online: 3 JAN 2009
- Article first published online: 3 JAN 2009
- Manuscript Accepted: 7 JAN 2004
- Sudden sensorineural HL;
Objective: To study the effectiveness of intratym-panic dexamethasone (IT-DEX) in patients with severe or profound sudden sensorineural hearing loss (SSNHL) after treatment failure with conventional therapy.
Study Design: Randomized, controlled study.
Methods: Patients who met the criteria for SSNHL, with a severity of severe to profound, underwent 10 days of standard treatment with oral steroid and other facilitating agents. Patients showing poor response to standard treatment were assigned randomly to a control group or to a group receiving IT-DEX. IT-DEX injections were performed once a week for 3 consecutive weeks. Pure-tone audiometry was obtained before each injection. Minimum follow-up time was 1 month. Successful treatment was defined as a hearing improvement of greater than 30 dB.
Results: Thirty-nine patients meeting the inclusion criteria were studied. After treatment with oral steroid, 10 of 39 (26%) patients demonstrated hearing improvement, whereas the remaining 29 (74%) patients showed a hearing improvement of less than 30 dB. For those without hearing improvement, 15 received IT-DEX, and 14 received further standard treatment (except oral steroid and carbogen inhalation). Hearing improved in 8 of 15 (53.3%) compared with 1 of 14 (7.1%), with an average decrease in threshold of 28.4 dB and 13.2 dB for the IT-DEX group and the control group, respectively (P < .05). Prognostic factors such as age, treatment delay time, and sex did not significantly affect the response to therapy.
Conclusions: IT-DEX injection effectively improves hearing in patients with severe or profound SSNHL after treatment failure with standard therapy and is not associated with major side effects. It is therefore a reasonable alternative as salvage treatment.