Intratympanic and Systemic Steroids for Sudden Hearing Loss

Koltsidopoulos, Petros; Bibas, Athanasios; Sismanis, Aristides; Τζώνου, Αναστασία; Seggas, Ioannis

doi:10.1097/mao.0b013e31828bb567

Cited by 55 publications

(44 citation statements)

References 22 publications

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“…Two studies [19,20] found that ITSI therapy was equivalent to systemic therapy in hearing level (HL) improvement, and one [21] found that combination therapy was similar to systemic steroids. Of the two studies [22,23] comparing systemic, ITSI and combination therapy, one found that combination therapy was superior to systemic treatment alone (87.5 vs 44.4 %).…”

Section: Resultsmentioning

confidence: 98%

Intratympanic corticosteroids injections: a systematic review of literature

Lavigne

Saliba

2015

Eur Arch Otorhinolaryngol

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The objective of the study was to determine the evidence of intratympanic steroids injections (ITSI) for efficacy in the management of the following inner ear diseases: Ménière's disease, tinnitus, noise-induced hearing loss (NIHL) and idiopathic sudden sensorineural hearing loss (ISSNHL). The data sources were literature review from 1946 to December 2014, PubMed and Medline. A systematic review of the existing literature was performed. Databases were searched for all human prospective randomized clinical trials using ITSI in at least one treatment group. The authors identified 29 prospective randomized clinical trials investigating the benefits of an intratympanic delivery of steroids. Six articles on Ménière's disease were identified, of which one favored ITSI over placebo in vertigo control. Of the five randomized clinical trials on tinnitus therapy, one study found better tinnitus control with ITSI. The only available trial on NIHL showed significant hearing recovery with combination therapy (ITSI and oral steroids therapy). Seventeen studies were identified on ISSNHL, of which 10 investigated ITSI as a first-line therapy and 7 as a salvage therapy. Studies analysis found benefits in hearing recovery in both settings. Due to heterogeneity in treatment protocols and follow-up, a meta-analysis was not performed. Given the low adverse effects rates of ITSI therapy and good patient tolerability, local delivery should be considered as an interesting adjunct to the therapy of the ISSNHL and NIHL. Only one article over six where ITSI therapy offers potential benefits to patients with Ménière's disease in the control of tinnitus and vertigo was found. ITSI does not seem to be effective in the treatment of tinnitus.

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Section: Resultsmentioning

confidence: 98%

Intratympanic corticosteroids injections: a systematic review of literature

Lavigne

Saliba

2015

Eur Arch Otorhinolaryngol

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“…However, the findings of the use of combination therapy in SSNHL have been inconsistent. Some studies found combination therapy promoted pure-tone average (PTA) improvement and a recovery rate similar to the use of systemic steroids alone [Arastou et al, 2013;Battaglia et al, 2008;Koltsidopoulos et al, 2013], and others have not [Lim et al, 2013]. A recent meta-analysis, which included eight studies, found that the combined therapy had better outcomes in PTA improvement and in recovery rate compared with systemic steroid use alone [Gao and Liu, 2016].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Concurrent or Sequential Intravenous and Intratympanic Steroid for Idiopathic Sudden Sensorineural Hearing Loss

Chu¹,

Chiou²,

Wang³

et al. 2018

Audiol Neurotol

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Objective: The purpose of this retrospective study was to investigate the difference in treatment outcomes for patients with idiopathic sudden sensorineural hearing loss (SSNHL) undergoing concurrent or sequential intravenous (IV) and intratympanic (IT) steroid therapies. Methods: Patients with idiopathic SSNHL admitted to Taipei Veterans Hospital from August 2011 to August 2012 were enrolled. Patients were treated with both IV dexamethasone 5 mg b.i.d. for 5 days, then tapered over 6 days, and IT injections of dexamethasone 5 mg daily. The administration of IV and IT steroids was given either concurrently or sequentially (IV steroid was administered from days 1–5 followed by IT steroid treatment starting on day 4 or day 5). The hearing outcomes of the concurrent and sequential groups were analyzed. Results: Overall, after ≥2 months following treatment, across frequencies ranging from 250 to 8,000 Hz and pure-tone average (PTA) assessments, hearing improvements were similar between treatment groups, except at the frequencies of 4,000 and 8,000 Hz where the concurrent treatment group had greater hearing gain than the sequential group (4,000 Hz: 30.68 ± 28.96 vs. 14.52 ± 24.06 dB, respectively, p = 0.042; 8,000 Hz: 22.62 ± 23.59 vs. 7.67 ± 21 dB, p = 0.030). Across frequencies and PTA assessments, a similar percentage of patients had ≥20-dB gains in hearing compared with patients treated sequentially, except at 8,000 Hz where a greater percentage of patients in the concurrent group (57.1%) than the sequential group (23.3%) (p = 0.014) had ≥20-dB hearing gains. Conclusion: The findings suggest that both concurrent and sequential treatment improve hearing in patients with idiopathic SSNHL, and that concurrent treatment may show greater benefit than sequential therapy, particularly at high frequencies.

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“…Battaglia et al [25] and Gundogan et al [29] reported better hearing improvement in ITS in combination with SS according to PTTA. On the other hand, Baysal et al [30] and Koltsidopoulos et al [31] concluded no superior hearing improvement of ITS in combination with SS.…”

Section: Discussionmentioning

confidence: 98%

Is There Any Effect of Addition of Hyperbaric Oxygen or Intratympanic Steroid to Systemic Steroids in Idiopathic Sudden Sensorineural Hearing Loss Treatment?

et al. 2020

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Background/aim: This study aims to determine the therapeutic superiority of the addition of intratympanic steroid or hyperbaric oxygen therapy to systemic steroid treatment in idiopathic sudden sensorineural hearing loss as initial treatment, and evaluate the longterm results of salvage treatment. Materials and methods:This study was a retrospective clinical trial with a total of 96 patients with idiopathic sudden sensorineural hearing loss. Patients were divided into 3 groups. Group 1 (n: 32) received systemic steroid treatment. Group 2 (n: 32) received the Group 1 protocol plus intratympanic steroid treatment. Group 3 (n: 32) received the Group 1 protocol plus hyperbaric oxygen treatment. Pretreatment and postinitial audiologic evaluations were performed, and the hearing outcome was analyzed with Furuhashi criteria. All patients, except those who experienced total recovery after initial treatment, were directed to salvage treatment. Audiologic assessment was performed again after salvage treatment and a mean follow-up period of 36.5 months.Results: Each group was homogenous according to demographics, audiologic data, and prognostic factors. There was no statistically significant difference in recovery and success rate within the 3 groups after initial treatment. (P: 0.66, P: 0.248, respectively). Successful results were obtained after salvage treatment in only 3 patients (5%). These patients received follow-up treatment at a mean of 36.5 months, but there was no spontaneous recovery after the end of salvage treatment. Conclusion:The addition of intratympanic steroids or hyperbaric oxygen to systemic steroids caused no significant hearing improvement as the initial treatment of idiopathic sudden sensorineural hearing loss. The efficacy of salvage treatment was limited, and there was no spontaneous hearing improvement after the long-term follow-up.

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Intratympanic and Systemic Steroids for Sudden Hearing Loss

Abstract: The addition of intratympanic steroids to the conventional systemic steroid therapy may provide a safe and potentially effective therapeutic option in patients with mild-to-severe ISSNHL.

Cited by 55 publications

References 22 publications

Intratympanic corticosteroids injections: a systematic review of literature

Intratympanic corticosteroids injections: a systematic review of literature

The Efficacy of Concurrent or Sequential Intravenous and Intratympanic Steroid for Idiopathic Sudden Sensorineural Hearing Loss

Is There Any Effect of Addition of Hyperbaric Oxygen or Intratympanic Steroid to Systemic Steroids in Idiopathic Sudden Sensorineural Hearing Loss Treatment?

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