Intratympanic Methylprednisolone Injection as First Line Therapy for Idiopathic Sudden Sensorineural Hearing Loss

Abstract

Introduction
 Steroid therapy is considered to be the gold standard for sudden sensorineural hearing loss (SSNHL). Delivering steroids by intratympanic injection is more efficient than systemic injections with minimum or no side effects. The present study was aimed to evaluate the efficacy and safety of intratympanic methylprednisolone injections as initial first line therapy for unilateral idiopathic SSNHL and the ease of giving it by otoendoscopy.
 Materials and Methods
 A prospective analysis was performed for the patients diagnosed as unilateral idiopathic SSNHL from April 2014 to April 2016 and receiving intratympanic steroids injections as first line therapy. Patients with unilateral sensorineural hearing loss of at least 30 dB at 3 contiguous frequencies occurring within a period of not more than 3 days are only included. All of the intratympanic steroid (ITS) injections were administered as OPD procedures. Each patient was treated by 3 injections given at 3 days interval. 
 Results
 A total of 22 patients who underwent primary intratympanic steroid (ITS) injection for unilateral SSNHL during the study period were included in the study. The mean age was 42.22 years (+ 9.79) and age ranged from 27 to 68 years. Patients included in our study came within 2nd to 27th day of occurrence of deafness and the mean duration (days) from onset of disease to start of ITS was 7.86 days. The average hearing gain in our study was 44.22 dB. In the present study 11 patients (50%) showed complete hearing improvement and 10 cases (45.45%) had partial and one (4.54%) showed no hearing recovery at 3 weeks follow up period.
 Conclusion
 Minimal systemic absorption with minimum or no systemic effects and high percentage of success rate encouraged the surgeons to prefer ITS as primary therapy for idiopathic unilateral SSNHL. It is effective, cheap, well-tolerated and can be performed as OPD procedure.