Intratympanic steroid therapy in moderate sudden hearing loss: A randomized, triple‐blind, placebo‐controlled trial

Filipo, Roberto; Attanasio, Giuseppe; Russo, Francesca; Viccaro, Marika; Mancini, Patrizia; Covelli, Edoardo

doi:10.1002/lary.23678

Cited by 63 publications

(72 citation statements)

References 20 publications

(40 reference statements)

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“…Although this concentration is lower than those used in prior publications (i.e., 12-62.5 mg/mL dexamethasone or 40 mg/mL methylprednisolone) for IT [Battaglia et al, 2014;Filipo et al, 2013;Seggas et al, 2011], there is still no consensus about the appropriate concentration or injection schedule for IT in SSNHL [Stachler et al, 2012]. Because the only commercially available concentration of dexamethasone in Korea is 5 mg/mL, several previous studies conducted in Korea have used the same dexamethasone concentration [Ahn et al, 2008;Kim et al, 2012;Lee et al, 2010;.…”

Section: Discussionmentioning

confidence: 71%

“…Previous reports including systematic reviews and meta-analyses have concluded that isolated initial IT steroids can be a valuable solution for patients with SSNHL who either cannot tolerate systemic steroid therapy or are refractory to it [Filipo et al, 2013;Seggas et al, 2011].…”

Section: Discussionmentioning

confidence: 99%

“…Although there are some reports that IT steroid therapy is as effective as oral steroid therapy or sequential therapy for SSNHL [Ho et al, 2004;Rauch et al, 2011;Yang et al, 2013], the efficacy of IT steroid as salvage treatment after systemic steroids has been demonstrated in many randomized controlled studies [Cvorovic et al, 2013;Filipo et al, 2013;Wu et al, 2011], and it is now recommended by several guidelines for SSNHL [Stachler et al, 2012]. Previous reports including systematic reviews and meta-analyses have concluded that isolated initial IT steroids can be a valuable solution for patients with SSNHL who either cannot tolerate systemic steroid therapy or are refractory to it [Filipo et al, 2013;Seggas et al, 2011].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Simultaneous versus Sequential Intratympanic Steroid Treatment for Severe-to-Profound Sudden Sensorineural Hearing Loss

et al. 2016

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Objectives: Severe-to-profound sudden sensorineural hearing loss (SSNHL) has a poor prognosis. We aimed to compare the efficacy of simultaneous and sequential oral and intratympanic steroids for this condition. Methods: Fifty patients with severe-to-profound SSNHL (>70 dB HL) were included from 7 centers. The simultaneous group (27 patients) received oral and intratympanic steroid injections for 2 weeks. The sequential group (23 patients) was treated with oral steroids for 2 weeks and intratympanic steroids for the subsequent 2 weeks. Pure-tone averages (PTA) and word discrimination scores (WDS) were compared before treatment and 2 weeks and 1 and 2 months after treatment. Treatment outcomes according to the modified American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria were also analyzed. Results: The improvement in PTA and WDS at the 2-week follow-up was 23 ± 21 dB HL and 20 ± 39% in the simultaneous group and 31 ± 29 dB HL and 37 ± 42% in the sequential group; this was not statistically significant. Complete or partial recovery at the 2-week follow-up was observed in 26% of the simultaneous group and 30% of the sequential group; this was also not significant. The improvement in PTA and WDS at the 2-month follow-up was 40 ± 20 dB HL and 37 ± 35% in the simultaneous group and 41 ± 25 dB HL and 48 ± 41% in the sequential group; this was not statistically significant. Complete or partial recovery at the 2-month follow-up was observed in 33% of the simultaneous group and 35% of the sequential group; this was also not significant. Seven patients in the sequential group did not need intratympanic steroid injections for sufficient improvement after oral steroids alone. Conclusions: Simultaneous oral/intratympanic steroid treatment yielded a recovery similar to that produced by sequential treatment. Because the addition of intratympanic steroids can be decided upon based on the improvement after an oral steroid, the sequential regimen can be recommended to avoid unnecessary intratympanic injections.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Simultaneous versus Sequential Intratympanic Steroid Treatment for Severe-to-Profound Sudden Sensorineural Hearing Loss

et al. 2016

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“…Consequently, almost all of the patients presented an up-sloping audiometric curve, known to be the curve with a higher spontaneous recovery rate [Mattox and Simmons, 1977]. Moreover, in a recent randomized triple-blind placebo-controlled trial it has been demonstrated that there was a statistical significance of the therapeutic action of the IT steroid therapy on moderate ISSNHL with flat audiogram shape compared to the natural course of the disease and to the placebo effect [Filipo et al, 2013].…”

Section: Discussionmentioning

confidence: 99%

Oral versus Short-Term Intratympanic Prednisolone Therapy for Idiopathic Sudden Hearing Loss

Filipo¹,

Attanasio²,

Russo³

et al. 2014

Audiol Neurotol

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Objectives: To assess the therapeutic effectiveness of an intratympanic (IT) steroid protocol compared to a systemic steroid protocol. Methods: A total of 265 consecutive patients presenting unilateral idiopathic sudden sensorineural hearing loss were divided into 2 groups. One group comprised 131 patients enrolled between May 2009 and May 2010, and the other consisted of 134 patients enrolled between June 2010 and June 2011; a total of 48 patients were excluded among the 2 groups. The first group received oral prednisone for 8 days in tapering doses; the second group had IT prednisolone at a dose of 62.5 mg/ml once a day for 3 consecutive days. Audiological examinations were performed at study entry and 30 days after the beginning of therapy. Mean pure tone audiometry (PTA) of both groups and hearing outcomes following the criteria of Furuhashi et al. [Clin Otolaryngol 2002;27:458-463] and Siegel [Otolaryngol Clin North Am 1975;8:467-473] were investigated. Results: The strong efficacy of steroid therapy was evident in both groups, observing both PTA and hearing threshold improvement. The evaluation of the hearing outcomes shows a significantly better result for the short-term IT protocol; this result is ascribable to two types of audiometric curves: down- and up-sloping. Conclusion: The results show a significant efficacy of both steroid therapeutic approaches. There was no significant difference in PTA improvement between the 2 study groups; the short-term IT protocol led to better results in the evaluation of the hearing outcomes (following the criteria of Siegel and Furuhashi et al.) for up- and down-sloping audiometric curves.

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“…SSNHL is generally unilateral, isolated and with variable clinical features in terms of hearing loss degree, accompanying symptoms and post-treatment outcomes. It was estimated that approximately half of SSNHL patients has a complete and spontaneous hearing recovery (Wilson et al, 1980;Filipo et al, 2013) even if a short course of corticosteroids is generally prescribed (Kuhn et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Sudden sensorineural hearing loss: is there a relationship between routine haematological parameters and audiogram shapes?

Salvago

Rizzo

Bianco

et al. 2016

International Journal of Audiology

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Objective: To investigate the relationship between haematological routine parameters and audiogram shapes in patients affected by sudden sensorineural hearing loss (SSNHL). Design: A retrospective study. All patients were divided into four groups according to the audiometric curve and mean values of haematological parameters (haemoglobin, white blood cell, neutrophils and lymphocytes relative count, platelet count, haematocrit, prothrombin time, activated partial thromboplastin time, fibrinogen and neutrophil-to-lymphocite ratio) of each group were statistically compared. The prognostic role of blood profile and coagulation test was also examined. Study sample: A cohort of 183 SSNHL patients without comorbidities. Results: With a 48.78% of complete hearing recovery, individuals affected by upsloping hearing loss presented a better prognosis instead of flat (18.36%), downsloping (19.23%) and anacusis (2.45%) groups (p ¼ 0.0001). The multivariate analysis of complete blood count values revealed lower mean percentage of lymphocytes (p ¼ 0.041) and higher platelet levels (p ¼ 0.015) in case of downsloping hearing loss; with the exception of fibrinogen (p ¼ 0.041), none of the main haematological parameters studied resulted associated with poorer prognosis. Conclusions: Our work suggested a lack of association between haematological parameters and a defined audiometric picture in SSNHL patients; furthermore, only fibrinogen seems to influence the prognosis of this disease.

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Intratympanic steroid therapy in moderate sudden hearing loss: A randomized, triple‐blind, placebo‐controlled trial

Cited by 63 publications

References 20 publications

Simultaneous versus Sequential Intratympanic Steroid Treatment for Severe-to-Profound Sudden Sensorineural Hearing Loss

Simultaneous versus Sequential Intratympanic Steroid Treatment for Severe-to-Profound Sudden Sensorineural Hearing Loss

Oral versus Short-Term Intratympanic Prednisolone Therapy for Idiopathic Sudden Hearing Loss

Sudden sensorineural hearing loss: is there a relationship between routine haematological parameters and audiogram shapes?

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