Steroid Use for Sudden Sensorineural Hearing Loss: A CHEER Network Study

Abstract

We observed that a majority of steroid-treated patients demonstrated hearing improvement, but this improvement did not meet criteria for statistical significance. As in other studies on this topic, the relatively small sample size may have prevented differentiation of effectiveness among steroid treatments. We propose that the use of alternative approaches, such as pragmatic clinical trials and multidisciplinary electronic health record systems and megadatabases, may hold the most promise for an approach to best practice development.

Intratympanically Delivered Steroids Impact Thousands More Inner Ear Genes Than Systemic Delivery

“…Recent clinical approaches for steroid delivery to the ear have employed intratympanic injections, either as a supplement to systemic delivery [3][4][5][6] or as the primary treatment. [5][6][7] The rationale is that a higher concentration of drugs reaches the cochlea through the round window. 8,9 However, in spite of claims of improved hearing recovery with intratympanic delivery, its efficacy over systemic delivery still is debated.…”

“…8,9 However, in spite of claims of improved hearing recovery with intratympanic delivery, its efficacy over systemic delivery still is debated. [5][6][7] As is the case with systemic delivery of steroids for hearing loss, no studies have fully documented the inner ear molecular functions influenced by this delivery method. These inner ear molecular functions of steroids must be understood before effective therapies can be established for the various forms of sensorineural hearing loss.…”