Intratympanic corticosteroid as salvage therapy in treatment of idiopathic sudden sensorineural hearing loss: A systematic review and meta-analysis

Devantier, Louise; Edemann-Callesen, Henriette; Jensen, Lasse Rehné; Mirian, Christian; Ovesen, Therese

doi:10.1016/j.heliyon.2022.e08955

Cited by 5 publications

(5 citation statements)

References 43 publications

(59 reference statements)

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“…The results of this study showed that the post-treatment pure-tone audiometry thresholds in Group A were significantly lower than those in Groups B and C, and Group B was lower than Group C, confirming that administering MPSS via tympanic injection on top of conventional drug therapy significantly improved the pure-tone audiometry thresholds for patients. As a novel glucocorticoid drug, MPSS can effectively alleviate local cochlear neuroinflammation and oedema, correct inner ear microvascular spasms, promote microvascular circulation and thus improve patients’ hearing thresholds[ 16 , 17 ]. When the drug is administered via the tympanic injection method, MPSS can directly act on the middle ear, reducing local inflammatory exudation, resolving swelling, improving the inflammatory condition in the middle ear and effectively alleviating otitis media in patients with SSNHL, promoting the recovery of hearing.…”

Section: Discussionmentioning

confidence: 99%

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

Meng,

Li,

Deng

2024

World J Clin Cases

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BACKGROUND Sudden sensorineural hearing loss (SSNHL), characterized by a rapid and unexplained loss of hearing, particularly at moderate to high frequencies, presents a significant clinical challenge. The therapeutic use of methylprednisolone sodium succinate (MPSS) via different administration routes, in combination with conventional medications, remains a topic of interest. AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid- to high-frequency SSNHL. METHODS The medical records of 109 patients with mid- to high-frequency SSNHL were analyzed. The patients were divided into three groups based on the route of administration: Group A [intratympanic (IT) injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection], Group B (intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection), and Group C (single IT injection of MPSS). The intervention effects were compared and analyzed. RESULTS The posttreatment auditory thresholds in Group A (21.23 ± 3 .34) were significantly lower than those in Groups B (28.52 ± 3.36) and C (30.23 ± 4.21; P < 0.05). Group A also exhibited a significantly greater speech recognition rate (92.23 ± 5.34) than Groups B and C. The disappearance time of tinnitus, time to hearing recovery, and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C (P < 0.05). The total effective rate in Group A (97.56%) was significantly greater than that in Groups B and C (77.14% and 78.79%, χ 2 = 7.898, P = 0.019). Moreover, the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B (4.88%, 3.03% vs 2.57%, χ 2 = 11.443, P = 0.003), and the recurrence rate in Group A was significantly lower than that in Groups B and C (2.44% vs 20.00% vs 21.21%, χ 2 = 7.120, P = 0.028). CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS. This approach effectively improves patients' hearing and reduces the risk of disease recurrence.

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Section: Discussionmentioning

confidence: 99%

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

Meng,

Li,

Deng

2024

World J Clin Cases

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“…A systematic review and meta-analysis conducted by Devantier et al (2022) support ITS as a safe and potentially useful therapy that increases the number of patients who recover (Devantier et al 2022). However, it is unknown which subgroups of patients will benefit the most from therapy.…”

Section: Discussionmentioning

confidence: 99%

“…When evaluating the concentrations of hydrocortisone, methylprednisolone, and dexamethasone in cochlear fluids following intravenous and topical treatment in well-designed animal research, endolymph and perilymph drug levels increased because of IT administration. Furthermore, the pharmacokinetic profile of methylprednisolone showed the most advantageous results, favoring methylprednisolone as the preferable therapeutic option (Devantier et al 2022).…”

Section: Discussionmentioning

confidence: 99%

“…Tinnitus and vertigo may be associated with SSNHL, which is usually unilateral (Schreiber et al 2010). The etiology of SSNHL remains unclear, despite many hypotheses regarding viral, circulatory, autoimmune, and metabolic disorders (Frosolini et al 2022) The incidence of SSNHL is estimated at 5 to 20 per 100,000 people yearly (Devantier et al 2022). Systemic steroids are the most commonly used first-line therapy for SSNHL, with hearing improvement rates cited at 61% of patients but with many studies questioning the efficacy of available treatment options (Wilson et al 1980).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Intratympanic Steroid and Hyperbaric Oxygen Salvage Therapy Hearing Outcomes in Idiopathic Sudden Sensorineural Hearing Loss: A Retrospective Study

et al. 2023

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Objectives: Systemic steroids are the most common first-line therapy in sudden sensorineural hearing loss (SSNHL), with significant improvement in hearing outcomes in over 60% of patients. It is unknown why 40% of patients do not respond to systemic steroid therapy. Salvage treatment includes intratympanic steroids (ITS) and hyperbaric oxygenation (HBO) therapy, with inconsistent results reported. This study aimed to compare the results of ITS and HBO therapy in patients with SSNHL that previously failed systemic steroid therapy. Design: This is a comparative retrospective nonrandomized interventional cohort study, enrolling 126 patients with SSNHL. Out of these, 35 patients received HBO therapy, 43 patients received ITS, and 48 patients did not receive any second-line therapy (control group). Pure-tone audiograms were performed before and after the salvage therapy in the IT and HBO groups and at the same time interval in the control group. Study variables included age, time until therapy initiation, tinnitus status, and hearing outcomes, with a cutoff criteria of cumulative >30 dB improvement on all frequencies indicating recovery. Results: ITS and HBO therapy were associated with statistically significant hearing recovery at all frequencies compared to systemic steroids. The results show an average hearing improvement of 13.6 dB overall frequencies (250 to 8000 Hz) after ITS therapy and 7.4 dB in HBO therapy in comparison to the control group. Presence of significant hearing improvement positively correlated with age, ITS therapy, and HBO therapy. Presence of tinnitus before therapy was negatively correlated with hearing improvement. Patients with tinnitus present at the start of therapy improve 4.67 dB less on average compared to those without tinnitus. ITS therapy significantly reduced tinnitus compared to the other two treatment options. Patients with tinnitus present before therapy significantly improve hearing at low frequencies, compared to the control group. Conclusions: ITS and HBO therapy show superior hearing results compared to observation alone after failed oral steroid therapy for SSNHL. ITS shows an additional positive impact on tinnitus reduction and shows superior hearing outcomes after salvage therapy.

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“…In our study, the use of salvage therapy with IT steroids did not show significant differences in auditory gain in decibels among the groups. Previous studies have demonstrated that IT salvage treatment with steroids can lead to significant improvement in hearing recovery [21,22], particularly in patients with total deafness [22]. However, the certainty of evidence is considered low to moderate due to potential bias.…”

Section: Salvage Therapymentioning

confidence: 99%

Exploring Audiologic Outcomes in Sudden Sensorineural Hearing Loss: A Retrospective Analysis

Espinosa-Arce,

Garcia-Lara,

Martinez-Servin

et al. 2024

Cureus

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Intratympanic corticosteroid as salvage therapy in treatment of idiopathic sudden sensorineural hearing loss: A systematic review and meta-analysis

Cited by 5 publications

References 43 publications

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

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

Comparison of Intratympanic Steroid and Hyperbaric Oxygen Salvage Therapy Hearing Outcomes in Idiopathic Sudden Sensorineural Hearing Loss: A Retrospective Study

Exploring Audiologic Outcomes in Sudden Sensorineural Hearing Loss: A Retrospective Analysis

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