Intratympanic corticosteroids for sudden sensorineural hearing loss

Plontke, Stefan K.; Meisner, Christoph; Agrawal, Sumit; Cayé‐Thomasen, Per; Galbraith, Kevin; Mikulec, Anthony A.; Parnes, Lorne S.; Premakumar, Yaamini; Reiber, Julia; Schilder, Anne G. M.; Liebau, Arne

doi:10.1002/14651858.cd008080.pub2

Cited by 32 publications

(24 citation statements)

References 141 publications

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“…5 Many studies have compared the 2 treatment methods, and according to a recent Cochrane review, there was no difference in treatment outcomes between SS and ITS as primary therapy. 6 However, recent results have shown that SS and ITS combination therapy is superior to SS monotherapy. 5,6 The combination of SS and ITS using different routes to the inner ear has the advantage of maximizing the steroid concentration in the inner ear, which may lead to better outcomes.…”

Section: Introductionmentioning

confidence: 99%

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The Effectiveness of Salvage Hyperbaric Oxygen Therapy Following Combined Steroid Therapy for Refractory Sudden Sensorineural Hearing Loss

Lee,

Kim,

Kong

et al. 2024

Ann Otol Rhinol Laryngol

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Objective: Hyperbaric oxygen therapy (HBOT) is an accepted treatment option for sudden sensorineural hearing loss (SSNHL), but it is still recommended in combination with corticosteroids. We investigated the efficacy of salvage HBOT in refractory SSNHL that does not respond to corticosteroid combination therapy. Methods: Eighty-four patients were included, who had unilateral SSNHL with an improvement of pure-tone average (PTA) less than 10 dB after using intratympanic plus systemic corticosteroids (combined therapy) as the initial therapy. The control group (n = 66) received no further treatment, and the HBOT group (n = 18) received additional treatment with HBOT (10 sessions in total with 2.5 atmospheres absolute for 1 hour). Results: No differences in PTA or WDS were found between the 2 groups. However, the mean hearing gain in the HBOT group (16.8 ± 4.49 dB) was significantly higher than that in the control group (4.45 ± 1.03 dB) ( P = .015). The proportion of patients with hearing recovery (hearing gain of 10 dB or more) after treatment was significantly higher in HBOT group (38.9%) than in the control group (10.6%). Conclusions: In patients with refractory SSNHL after steroid combined therapy, salvage HBOT showed a significant effect on hearing gain and recovery rate.

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Section: Introductionmentioning

confidence: 99%

“…6 However, recent results have shown that SS and ITS combination therapy is superior to SS monotherapy. 5,6 The combination of SS and ITS using different routes to the inner ear has the advantage of maximizing the steroid concentration in the inner ear, which may lead to better outcomes.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Salvage Hyperbaric Oxygen Therapy Following Combined Steroid Therapy for Refractory Sudden Sensorineural Hearing Loss

Lee,

Kim,

Kong

et al. 2024

Ann Otol Rhinol Laryngol

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“…Only a small number of topically delivered medications with effects on the inner ear are widely used in routine clinical practice. These include aminoglycosides for the treatment of Meniere’s disease ( Basura et al, 2020 ) and the therapeutic use of corticosteroids, e.g., in idiopathic sudden sensorineural hearing loss ( Chandrasekhar et al, 2019 ; Dahm et al, 2021 ; Plontke et al, 2022 ). In the scope of local drug delivery to the inner ear, various medications such as antibiotics, steroids, antioxidants, biologicals (Roemer 2017), and promising gene or stem cell therapy alternatives are explored today ( Staecker and Rodgers, 2013 ; Warnecke et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Investigation of inner ear drug delivery with a cochlear catheter in piglets as a representative model for human cochlear pharmacokinetics

et al. 2023

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Hearing impairment is the most common sensory disorder in humans, and yet hardly any medications are licensed for the treatment of inner ear pathologies. Intricate pharmacokinetic examinations to better understand drug distribution within this complex organ could facilitate the development of novel therapeutics. For such translational research projects, animal models are indispensable, but differences in inner ear dimensions and other anatomical features complicate the transfer of experimental results to the clinic. The gap between rodents and humans may be bridged using larger animal models such as non-human primates. However, their use is challenging and impeded by administrative, regulatory, and financial hurdles. Other large animal models with more human-like inner ear dimensions are scarce. In this study, we analyzed the inner ears of piglets as a potential representative model for the human inner ear and established a surgical approach for intracochlear drug application and subsequent apical sampling. Further, controlled intracochlear delivery of fluorescein isothiocyanate-dextran (FITC-d) was carried out after the insertion of a novel, clinically applicable CE-marked cochlear catheter through the round window membrane. Two, six, and 24 hours after a single injection with this device, the intracochlear FITC-d distribution was determined in sequential perilymph samples. The fluorometrically assessed concentrations two hours after injection were compared to the FITC-d content in control groups, which either had been injected with a simple needle puncture through the round window membrane or the cochlear catheter in combination with a stapes vent hole. Our findings demonstrate not only significantly increased apical FITC-d concentrations when using the cochlear catheter but also higher total concentrations in all perilymph samples. Additionally, the concentration decreased after six and 24 hours and showed a more homogenous distribution compared to shorter observation times.

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“…Systemic steroid treatment (intravenous or peroral) is the mainstay therapy for ISSNHL 5,6 . However, intratympanic (IT) steroid injection has been indicated as an alternative to systemic steroid treatment for ISSNHL 7,8 . Some studies have reported higher rates of hearing recovery in patients with ISSNHL receiving both systemic steroid treatment and IT steroid injection than in those receiving systemic steroids alone 9,10 .…”

Section: Introductionmentioning

confidence: 99%

Primary versus salvage intratympanic steroid treatment for idiopathic sudden sensorineural hearing loss

Lan

Lin

Tsou

et al. 2023

Laryngoscope Investig Oto

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ObjectiveThe objective of this research is to compare primary and salvage intratympanic (IT) steroid treatments in terms of hearing outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).MethodsThe patients were randomized into two (primary and salvage) groups. Both groups received systemic steroid treatment for 2 weeks. The primary group also received IT dexamethasone injection three times during the treatment period, whereas the salvage group received IT dexamethasone injection only if no or slight recovery was noted at the 2‐week follow‐up. If needed, salvage steroid injection was administered three times during the following 2 weeks. Hearing recovery was analyzed according to the modified American Academy of Otolaryngology‐Head and Neck Surgery criteria.ResultsThe degrees of hearing improvement at the 3‐month follow‐up were similar in the two groups. Compared with baseline, the pure‐tone average values and speech discrimination scores improved by 38.45 ± 21.95 dB HL and 34.32% ± 30.55%, respectively, in the primary group and 36.80 ± 22.33 dB HL and 31.87% ± 27.88%, respectively, in the salvage group (p = .762 and .659, respectively). In addition, the complete or partial hearing recovery rates were also similar in the primary and salvage groups (67.7% vs. 73.3%, respectively; p = .780). In the salvage group, 18 patients required no IT steroid injection because they recovered after systemic steroid treatment.ConclusionPrimary and salvage IT steroid treatments for ISSNHL led to similar outcomes. In summary, salvage IT steroid injection is recommended for patients with ISSNHL patients to prevent unnecessary IT injection.Level of evidence2.

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Intratympanic corticosteroids for sudden sensorineural hearing loss

Abstract: Intratympanic corticosteroids for sudden sensorineural hearing loss (Review)

Cited by 32 publications

References 141 publications

The Effectiveness of Salvage Hyperbaric Oxygen Therapy Following Combined Steroid Therapy for Refractory Sudden Sensorineural Hearing Loss

The Effectiveness of Salvage Hyperbaric Oxygen Therapy Following Combined Steroid Therapy for Refractory Sudden Sensorineural Hearing Loss

Investigation of inner ear drug delivery with a cochlear catheter in piglets as a representative model for human cochlear pharmacokinetics

Primary versus salvage intratympanic steroid treatment for idiopathic sudden sensorineural hearing loss

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