Metilprednisolona intratimpânica como terapia de resgate na surdez neurossensorial súbita

Raymundo, Igor Teixeira; Bahmad, Fayez; Filho, Jairo Barros; Pinheiro, Thaís Gonçalves; Maia, Nilda Agostinho; Oliveira, Carlos Augusto Costa Pires de

doi:10.1590/s1808-86942010000400015

Cited by 14 publications

(1 citation statement)

References 56 publications

(281 reference statements)

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“…Currently, in addition to therapeutic approaches such as oral steroids and/or intratympanic methylprednisolone 9 and vasodilators for sudden deafness, which are most commonly used options due mainly prescription is easily associated with the low cost, there are still therapeutic approaches such as the use hyperbaric oxygen therapy (HOT) 2 and cochlear implant 10 . However, corticosteroids seem to have universal acceptance and are the ones with proven effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Intratympanic corticotherapy and tinnitus control after sudden hearing loss

Barreto¹,

Silva²,

Oliveira³

et al. 2012

The International Tinnitus Journal

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Section: Discussionmentioning

confidence: 99%

Intratympanic corticotherapy and tinnitus control after sudden hearing loss

Barreto¹,

Silva²,

Oliveira³

et al. 2012

The International Tinnitus Journal

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Corticosteroid Therapy for Hearing and Balance Disorders

Trune

Canlon

2012

The Anatomical Record

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This review addresses the current status of steroid therapies for hearing and vestibular disorders and how certain misconceptions may be undermining the efficacy in restoring normal ear function, both experimentally and clinically. Specific misconceptions addressed are that steroid therapy is not effective, steroid-responsive hearing loss proves an underlying inflammatory problem in the ear, and steroids only have application to the hearing disorders listed below. Glucocorticoid therapy for hearing and balance disorders has been employed for over 60 years. It is recommended in cases of sudden hearing loss, Meniére’s disease, immune-mediated hearing loss, and any vestibular dysfunction suspected of having an inflammatory etiology. The predominant steroids employed today are dexamethasone, prednisone, prednisolone, and methyl-prednisolone. In spite of years of use, little is known of the steroid responsive mechanisms in the ear that are influenced by glucocorticoid therapy. Furthermore, meta-analyses and clinical study reviews occasionally question whether steroids offer any benefit at all. Foremost in the minds of clinicians is the immune suppression and antiinflammatory functions of steroids because of their efficacy for autoimmune hearing loss. However, glucocorticoids have a strong binding affinity for the mineralocorticoid (aldosterone) and glucocorticoid receptors, both of which are prominent in the ear. Because the auditory and vestibular end organs require tightly regulated endolymph and perilymph fluids, this ion homeostasis role of the mineralocorticoid receptor cannot be overlooked in both normal and pathologic functions of the ear. The function of the glucocorticoid receptor is to provide anti-inflammatory and anti-apoptotic signals by mediating survival factors.

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Are intra-tympanically administered steroids effective in patients with sudden deafness? Implications for current clinical practice

Vlastarakos

Papacharalampous

Maragoudakis³

et al. 2011

Eur Arch Otorhinolaryngol

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Over 60 years since its first report, sudden sensorineural hearing loss (SSNHL) still represents an ill-explained condition, with potentially devastating effects for the quality of life of previously well patients. The present study critically reviewed the available evidence regarding the efficacy of intra-tympanic steroid administration in the treatment of SSNHL. Factors affecting that efficacy were also explored. The literature was systematically reviewed in Medline and other database sources until July 2011, and analyzed through critical analysis of pooled data. The study selection included multi-center prospective randomized control trials, prospective randomized comparative, prospective comparative and prospective studies, retrospective comparative and retrospective studies. The total number of analyzed studies was 43. Intra-tympanic steroids appear to be effective as primary (strength of recommendation A), or salvage treatment (strength of recommendation B) in SSNHL. It is difficult to draw definite conclusions regarding the efficacy of combination therapy. The identification of a time window for effective treatment in the former two approaches yields a grade C strength of recommendation. Primary intra-tympanic treatment is the most effective modality in terms of complete hearing recovery (34.4% cure rate). There is not enough evidence to attribute treatment failures to impaired permeability of the round window membrane. Most complications of intra-tympanic treatment are minor, temporary, and conservatively managed. Intra-tympanic steroids can theoretically provide a more organ-specific treatment in patients with SSNHL. The observation that they seem effective both as primary and salvage treatment modalities with a very low complication rate may have serious implications for current clinical practice.

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Metilprednisolona intratimpânica como terapia de resgate na surdez neurossensorial súbita

Cited by 14 publications

References 56 publications

Intratympanic corticotherapy and tinnitus control after sudden hearing loss

Intratympanic corticotherapy and tinnitus control after sudden hearing loss

Corticosteroid Therapy for Hearing and Balance Disorders

Are intra-tympanically administered steroids effective in patients with sudden deafness? Implications for current clinical practice

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