Efficacy of intratympanic or postauricular subperiosteal corticosteroid injection combined with systemic corticosteroid in the treatment of sudden sensorineural hearing loss: A prospective randomized study

Abstract

ObjectivesThis study aimed to investigate the efficacy and safety of intratympanic or postauricular subperiosteal glucocorticoid injection combined with systemic glucocorticoid in the treatment of sudden sensorineural hearing loss (SSNHL).MethodsThis study is a prospective randomized controlled study. This study included unilateral SSNHL patients who were hospitalized in our department between January 2020 and June 2021. Patients were randomly divided into three groups (groups A, B, and C). Patients in group A were treated with an intratympanic corticosteroid injection combined with systemic corticosteroid treatment, and patients in group B received a postauricular corticosteroid injection combined with systemic corticosteroid treatment. Patients in group C (control group) were treated with systemic corticosteroid alone. The case number of groups A, B, and C was 311, 375, and 369, respectively.ResultsThere was no significant difference in gender distribution, the proportion of left and right affected ears, and the average interval from onset to treatment among the three groups (P > 0.05). However, there were significant differences in their average age, distribution of audiogram type, and hearing loss levels among them (P < 0.01). Our study shows that there was no significant difference in average hearing threshold improvement before and after treatment in the three groups (P > 0.05). Regarding the complications, in group A, 33 patients (10.6%) had a transient vertigo attack during tympanic injection, which lasted for ~1–3 min. In group B, 20 patients (6.43%) complained of pain at the injection site, which disappeared after 1–3 days. No other complications occurred in all the other patients.ConclusionThe addition of intratympanic or postauricular corticosteroid to systemic steroids did not result in a significant effect on hearing recovery in SSNHL. No obvious complications occur in SSNHL patients treated with intratympanic injection or postauricular injection of corticosteroid.Clinical trial registration[chictr.org.cn], registration number: ChiCTR2100048762.

Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid- to high-frequency sudden sensorineural hearing loss

“…Xie et al [ 22 ] and Yamamoto et al [ 23 ] indicated that IT steroid injection does not damage the inner ear, with insignificant histological or cochlear functional changes. IT injection was shown to be a safe treatment method in the study, with no major complications.…”

Overcoming barriers: a review on innovations in drug delivery to the middle and inner ear

“…This has the advantage of avoiding potential side effects of intratympanic injection such as persistent pain, otitis media or acute or chronic tympanic perforation. ( Li et al, 2021 ; Chen et al, 2022c ; Xie et al, 2023 ). However, it is currently not performed worldwide and it remains unclear how drugs reach the inner ear from the postauricular region ( Qiu et al, 2022 ).…”