Simultaneous versus Subsequent Intratympanic Dexamethasone for Idiopathic Sudden Sensorineural Hearing Loss

Park, Moo Kyun; Lee, Chi-Kyou; Park, Kye Hoon; Lee, Jong Dae; Lee, Chan Goo; Lee, Byung Don

doi:10.1177/0194599811418169

Cited by 33 publications

(54 citation statements)

References 22 publications

(53 reference statements)

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“…If the 10 patients within 2 weeks from the onset were excluded to eliminate the effect from nature spontaneous recovery, 43.5% patients (27/62) showed clear or partial improvement. These results were similar to or higher than average recovery rate of other studies especially considering the time interval from onset of ISSHL to start treatment ( Xenellis J et al, 2006;Haynes DS et al, 2007;Raymundo IT et al, 2010;Wu HP et al, 2011;Rauch SD et al, 2011;Park MK et al, 2011).…”

Section: Fig 3 Decision Tree Model Of Important Variables As Prognosupporting

confidence: 88%

Effects and Prognostic Factors of Acupuncture Treatment for Idiopathic Sudden Sensorineural Hearing Loss

Kim¹,

Nam²

2012

Hearing Loss

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Section: Fig 3 Decision Tree Model Of Important Variables As Prognosupporting

confidence: 88%

Effects and Prognostic Factors of Acupuncture Treatment for Idiopathic Sudden Sensorineural Hearing Loss

Kim¹,

Nam²

2012

Hearing Loss

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“…A prior study by Park et al [2011] also compared simultaneous systemic and IT steroid treatment with successive systemic and IT therapy . Both groups received IV dexamethasone for 7 days (including a tapering dose for 2 days) and an oral tapered dose for 3 days.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Concurrent or Sequential Intravenous and Intratympanic Steroid for Idiopathic Sudden Sensorineural Hearing Loss

Chu¹,

Chiou²,

Wang³

et al. 2018

Audiol Neurotol

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Objective: The purpose of this retrospective study was to investigate the difference in treatment outcomes for patients with idiopathic sudden sensorineural hearing loss (SSNHL) undergoing concurrent or sequential intravenous (IV) and intratympanic (IT) steroid therapies. Methods: Patients with idiopathic SSNHL admitted to Taipei Veterans Hospital from August 2011 to August 2012 were enrolled. Patients were treated with both IV dexamethasone 5 mg b.i.d. for 5 days, then tapered over 6 days, and IT injections of dexamethasone 5 mg daily. The administration of IV and IT steroids was given either concurrently or sequentially (IV steroid was administered from days 1–5 followed by IT steroid treatment starting on day 4 or day 5). The hearing outcomes of the concurrent and sequential groups were analyzed. Results: Overall, after ≥2 months following treatment, across frequencies ranging from 250 to 8,000 Hz and pure-tone average (PTA) assessments, hearing improvements were similar between treatment groups, except at the frequencies of 4,000 and 8,000 Hz where the concurrent treatment group had greater hearing gain than the sequential group (4,000 Hz: 30.68 ± 28.96 vs. 14.52 ± 24.06 dB, respectively, p = 0.042; 8,000 Hz: 22.62 ± 23.59 vs. 7.67 ± 21 dB, p = 0.030). Across frequencies and PTA assessments, a similar percentage of patients had ≥20-dB gains in hearing compared with patients treated sequentially, except at 8,000 Hz where a greater percentage of patients in the concurrent group (57.1%) than the sequential group (23.3%) (p = 0.014) had ≥20-dB hearing gains. Conclusion: The findings suggest that both concurrent and sequential treatment improve hearing in patients with idiopathic SSNHL, and that concurrent treatment may show greater benefit than sequential therapy, particularly at high frequencies.

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“…Intratympanic (IT) steroid injection for SSNHL is considered the treatment of choice for SSNHL patients with contraindications for oral steroids or as salvage after oral steroids [Ho et al, 2004;Kim et al, 2012;Lee et al, 2011;Stachler et al, 2012]. However, the efficacy of simultaneous (oral and IT steroids at the same time) treatment is not clear [Ahn et al, 2008;Arslan et al, 2011;Park et al, 2011], and simultaneous treatment did not confer an additional hearing gain or an earlier recovery rate compared to sequential (oral and salvage IT steroid) treatment in recent prospective studies [Lim et al, 2013;Park et al, 2011].…”

Section: Introductionmentioning

confidence: 99%

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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Simultaneous versus Subsequent Intratympanic Dexamethasone for Idiopathic Sudden Sensorineural Hearing Loss

Cited by 33 publications

References 22 publications

Effects and Prognostic Factors of Acupuncture Treatment for Idiopathic Sudden Sensorineural Hearing Loss

Effects and Prognostic Factors of Acupuncture Treatment for Idiopathic Sudden Sensorineural Hearing Loss

The Efficacy of Concurrent or Sequential Intravenous and Intratympanic Steroid for Idiopathic Sudden Sensorineural Hearing Loss

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

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