Our experience in intratympanic vs intravenous steroids for Idiopathic Sudden Sensorineural Hearing Loss

Kosyakov, Sergey; Gunenkov, A. V.; Atanesyan, A. G.; Ashkhatunyan, Edgar

doi:10.14748/orl.v11i3.6862

Cited by 4 publications

(9 citation statements)

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“…For instance, Kosyakov et al found that the intratympanic group had a more pronounced PTA improvement in the verbal frequencies than the systemic group. 16 Filipo et al obtained similar results after a fairly short course of treatment in a pool of 217 patients. 17 In a meta-analysis conducted by Lai et al, although the intratympanic and systemic therapies appeared to present similar efficiency, the authors still recommended a local approach as initial therapy due to the lower possibility of steroid use-associated side effects.…”

Section: Discussionmentioning

confidence: 67%

Comparison of 2 Different Intratympanic Methylprednisolone Injection Schedules in Combination With Intravenous Dexamethasone for Unilateral Sudden Sensorineural Hearing Loss

et al. 2020

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Sudden sensorineural hearing loss is a common otologic disease in clinic. Systemic and intratympanic steroid treatment have been proved to be effective, but the regimens vary from center to center. The purpose of the study is to analyze the effects of the combined application of intravenous dexamethasone and intratympanic methylprednisolone injection in different time strategies for the treatment of unilateral sudden sensorineural hearing loss. A retrospective chart review was performed for the period from March 2016 to June 2018 at our Department of Otorhinolaryngology—Head and Neck Surgery. A total number of 61 patients who met the academy criteria for unilateral sudden hearing loss were included and grouped based on the time to introduce intratympanic methylprednisolone. All the patients received intravenous dexamethasone 10 mg once daily for 5 days, followed 5 mg once daily for the next 7 days. Intratympanic methylprednisolone (40 mg) was injected every other day 4 times into all patients. This regimen was commenced on day 1 in group 1 and on day 6 in group 2. The pre and posttreatment pure-tone audiograms were analyzed. Sixty-one patients met our inclusion criteria. No significant differences were observed between patients’ demographics or pretreatment hearing thresholds. In the 3 months posttreatment pure-tone audiogram assessment, the mean hearing threshold improvement were similar between groups with no frequency specificity. The curative rate in both groups were similar and satisfying. Two patients with diabetes mellitus had persistent small perforations. Some patients had other transient discomfort that disappeared before discharge. The different timing of initiation of intratympanic methylprednisolone injection does not significantly affect the outcome of the treatment for sudden sensorineural hearing loss. Thus, we suggest that intratympanic steroid injection should not be applied as a first-line method except for patients who do not respond early to systemic steroid therapy.

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Section: Discussionmentioning

confidence: 67%

Comparison of 2 Different Intratympanic Methylprednisolone Injection Schedules in Combination With Intravenous Dexamethasone for Unilateral Sudden Sensorineural Hearing Loss

et al. 2020

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“…Different treatment protocols have been used from the included studies [10][11][12][13][14][15][16][17][18][19][20][21], either for intratympanic treatment or for systemic treatment. This heterogenicity may affect our results.…”

Section: Discussionmentioning

confidence: 99%

“…PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analysis [9] Table 1 presents the characteristics of each of the selected studies [10][11][12][13][14][15][16][17][18][19][20][21] included in the study.…”

Section: Figure 1: Flowchart Of the Process Of Study Selectionmentioning

confidence: 99%

Intratympanic Versus Systemic Steroid Therapy for Idiopathic Sudden Hearing Loss: A Systematic Review and Meta-Analysis

Sialakis¹,

Iliadis²,

Frantzana³

et al. 2022

Cureus

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Idiopathic sudden sensorineural hearing loss (ISSHL) is a common condition characterized by hearing threshold reduction, most often of unknown causes. The patient experiences a sudden reduction of the hearing threshold in one or both ears. Steroids are the mainstream of the treatment. This study aims to investigate the effectiveness of intratympanic steroid administration compared with systemic administration and the combination of the two steroid treatments in the hearing recovery of patients with idiopathic sudden sensorineural hearing loss. We searched electronic databases such as PubMed,

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“…The most widely accepted systemic steroidal dose for optimal treatment outcomes is 1 mg/kg oral prednisone in a single daily dose, with the usual maximum dose of 60 mg daily and treatment duration of 10 to 14 days 18,19 . This regimen, however, is associated with potential side effects, including gastric ulcers, hyperglycemia, elevated blood pressure, and femoral head necrosis 20 …”

Section: Discussionmentioning

confidence: 99%

“…18,19 This regimen, however, is associated with potential side effects, including gastric ulcers, hyperglycemia, elevated blood pressure, and femoral head necrosis. 20 The IT route as initial therapy showed no overall advantage over systemic steroids, 21 and it is either reserved as a salvage therapy or given as initial therapy when systemic administration is contraindicated. The IT route can be used for successive injections with a 25-gauge spinal needle.…”

Section: Discussionmentioning

confidence: 99%

Residual Perforation Risk Assessment of Intratympanic Steroids via Tympanostomy Tube Versus Transtympanic Injections

et al. 2021

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Objectives/Hypothesis To investigate the risk of residual tympanic membrane (TM) perforation after intratympanic (IT) steroidal treatment administered via transtympanic injection compared with trans‐tympanostomy tube (TyT). Study Design Case series, systematic review and meta analysis. Methods Data were retrieved from the medical files of an original cohort of all consecutive patients with sudden sensorineural hearing loss necessitating IT steroidal treatment in a tertiary medical center between January 1, 2016 and November 20, 2020. A systematic literature search of “MEDLINE” via “PubMed,” “Embase,” and “Web of Science” on comparable published cases was performed and meta‐analysis was established. Results Eighteen studies describing 818 ears were included in the quantitative meta‐analysis in addition to a local cohort of 140 ears. The proportion of residual TM perforation was 1.11% and 1.14% (95% confidence interval: 0.01%–3.27% and 0.028%–2.38%) in the TyT and trans‐tympanic groups, respectively, suggesting no significant difference in residual TM perforation risk between these techniques. Conclusion IT steroid therapy via trans‐TyT is not associated with more residual perforations than IT steroid therapy via transtympanic injections. Level of Evidence NA Laryngoscope, 131:E2583–E2591, 2021

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Our experience in intratympanic vs intravenous steroids for Idiopathic Sudden Sensorineural Hearing Loss

Cited by 4 publications

References 0 publications

Comparison of 2 Different Intratympanic Methylprednisolone Injection Schedules in Combination With Intravenous Dexamethasone for Unilateral Sudden Sensorineural Hearing Loss

Comparison of 2 Different Intratympanic Methylprednisolone Injection Schedules in Combination With Intravenous Dexamethasone for Unilateral Sudden Sensorineural Hearing Loss

Intratympanic Versus Systemic Steroid Therapy for Idiopathic Sudden Hearing Loss: A Systematic Review and Meta-Analysis

Residual Perforation Risk Assessment of Intratympanic Steroids via Tympanostomy Tube Versus Transtympanic Injections

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