Intratympanic Steroids in Severe to Profound Sudden Sensorineural Hearing Loss as Salvage Treatment
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Objectives. Intratympanic steroids are being increasingly used in the treatment of sudden sensorineural hearing loss (SSNHL)after the failure of systemic therapy. This study evaluated the efficacy of administering intratympanic dexamethasone (ITD) as a salvage treatment for severe to profound SSNHL. Methods. We reviewed the medical records of patients who presented with severe to profound SSNHL between January 2007 and December 2009. ITD was given about 14 days after the initial systemic treatment. Successful recovery was defined as complete or partial recovery using Sigel’s criteria. We compared the results of treatment between the severe SSNHL (S-SSNHL) and profound SSNHL (P-SSNHL) groups. Results. All the patients in the S-SSNHL group showed significant improvement, as compared to the P-SSNHL group (P=0.017). The recovery rate after the initial systemic treatment was 36% (9/25) in the S-SSNHL group and 18.1% (4/22) in the P-SSNHL group (P=0.207). In comparison, the recovery rate of ITD as a salvage treatment was 37.5% (6/16) in the S-SSNHL group and 5.5% (1/18) in the P-SSNHL group (P=0.03). Conclusion. Our comparative study dose not support the efficacy of ITD as salvage treatment for patients with P-SSNHL as compared with that for S-SSNHL. We recommend that patients with P-SSNHL be informed about the low efficacy of ITD as a salvage treatment.
Abstract
Objectives. Intratympanic steroids are being increasingly used in the treatment of sudden sensorineural hearing loss (SSNHL)after the failure of systemic therapy. This study evaluated the efficacy of administering intratympanic dexamethasone (ITD) as a salvage treatment for severe to profound SSNHL. Methods. We reviewed the medical records of patients who presented with severe to profound SSNHL between January 2007 and December 2009. ITD was given about 14 days after the initial systemic treatment. Successful recovery was defined as complete or partial recovery using Sigel’s criteria. We compared the results of treatment between the severe SSNHL (S-SSNHL) and profound SSNHL (P-SSNHL) groups. Results. All the patients in the S-SSNHL group showed significant improvement, as compared to the P-SSNHL group (P=0.017). The recovery rate after the initial systemic treatment was 36% (9/25) in the S-SSNHL group and 18.1% (4/22) in the P-SSNHL group (P=0.207). In comparison, the recovery rate of ITD as a salvage treatment was 37.5% (6/16) in the S-SSNHL group and 5.5% (1/18) in the P-SSNHL group (P=0.03). Conclusion. Our comparative study dose not support the efficacy of ITD as salvage treatment for patients with P-SSNHL as compared with that for S-SSNHL. We recommend that patients with P-SSNHL be informed about the low efficacy of ITD as a salvage treatment.
참고문헌 (15)
- Wilson WR, "The efficacy of steroids in the treatment of idiopathic sudden hearing loss: a double-blind clinical study", Arch Otolaryngol, 106(12), pp.772~776 (1980)
- Byl FM Jr, "Sudden hearing loss: eight years’ experience and suggested prognostic table", Laryngoscope, 94(5 Pt 1), pp.647~661 (1984)
- Mattox DE, "Idiopathic sudden sensorineural hearing loss", Am J Otol, 10(3), pp.242~247 (1989)
- Moskowitz D, "Steroid use in idiopathic sudden sensorineural hearing loss", Laryngoscope, 94(5 Pt 1), pp.664~666 (1984)
- Parnes LS, "Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application", Laryngoscope, 109(7 Pt 2), pp.1~17 (1999)
- Chandrasekhar SS, "Dexamethasone pharmacokinetics in the inner ear: comparison of route of administration and use of facilitating agents. Otolaryngol Head Nec", Otolaryngol Head Neck Surg., 122(4)통권 : 5, pp.521~527 (2000)
- Hu A, "Intratympanic steroids for inner ear disorders: a review", Audiol Neurootol, 14(6), pp.373~382 (2009)
- Battaglia A, "Combination therapy (intratympanic dexamethasone + high-dose prednisone taper) for the treatment of idiopathic sudden sensorineural hearing loss", Otol Neurotol, 29(4), pp.453~460 (2008)
- Ahn JH, "Can intratympanic dexamethasone added to systemic steroids improve hearing outcome in patients with sudden deafness?", Laryngoscope, 118(2), pp.279~282 (2008)
- Kara E, "Modified intratympanic treatment for idiopathic sudden sensorineural hearing loss", Eur Arch Otorhinolaryngol, 267(5), pp.701~707 (2010)
- Hong SM, "Hearing outcomes of daily intratympanic dexamethasone alone as a primary treatment modality for ISSHL", Otolaryngol Head Neck Surg., 141(5), pp.579~583 (2009)
- Han CS, "Clinical efficacy of initial intratympanic steroid treatment on sudden sensorineural hearing loss with diabetes", Otolaryngol Head Neck Surg, 141(5), pp.572~578 (2009)
- Haynes DS, "Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy", Laryngoscope, 117(1), pp.3~15 (2007)
- Ho HG, "Effectiveness of intratympanic dexamethasone injection in sudden-deafness patients as salvage treatment", Laryngoscope, 114(7), pp.1184~1189 (2004)
- Moon IS, "How long should the sudden hearing loss patients be followed after early steroid combination therapy?", Eur Arch Otorhinolaryngol, 266(9), pp.1391~1395 (2009)