돌발성 난청 환자에서 고실 내 스테로이드 투여 약제에 따른 치료 효과 비교
Comparison of the Effect of Intratympanic Steroid Injection Medications in Patients with Idiopathic Sudden Sensorineural Hearing Loss
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Background and Objectives This study is aimed to investigate the efficacy of dexamethasone and methylprednisolone when used for Intratympanic steroid injection (ITSI) concurrent with systemic steroid as primary therapy. Subjects and Method We undertook a retrospective study of 106 patients diagnosed with Idiopathic Sudden Sensorineural Hearing Loss at our institution. These patients were divided into the following groups based on their intratympanic steroid medications: Group 1 (which received dexamethasone for ITSI) and Group 2 (which received methylprednisolone for ITSI). The severity of pain after ITSI was also compared using Visual Analogue Scale. Results The therapeutic results of both groups showed no significant difference. The improvement of pure tone audiometry average threshold were 18.3±19.5 dB for Group 1 and 22.4±25.8 dB for Group 2, with no significant differences (p=0.402). The recovery rate according to Siegel’s criteria were 34/70 (48.6%) and 18/36 (50.0%) respectively, with no significant differences (p=0.889). The degree of pain after ITSI were 1.51±1.06 and 3.92±1.63 for Group 1 and 2, respectively, showing significant differences (p＜0.001). Again, there were no significant differences even when accompanying symptoms or severity of initial hearing loss were considered. Conclusion There was no significant difference between efficacy of dexamethasone and methylprednisolone when used as primary therapy. Methylprednisolne caused more severe pain after ITSI, suggesting the choice of dexamethasone. Further studies are needed about the concentration of injected steroid. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(9):441-8
Abstract
Background and Objectives This study is aimed to investigate the efficacy of dexamethasone and methylprednisolone when used for Intratympanic steroid injection (ITSI) concurrent with systemic steroid as primary therapy. Subjects and Method We undertook a retrospective study of 106 patients diagnosed with Idiopathic Sudden Sensorineural Hearing Loss at our institution. These patients were divided into the following groups based on their intratympanic steroid medications: Group 1 (which received dexamethasone for ITSI) and Group 2 (which received methylprednisolone for ITSI). The severity of pain after ITSI was also compared using Visual Analogue Scale. Results The therapeutic results of both groups showed no significant difference. The improvement of pure tone audiometry average threshold were 18.3±19.5 dB for Group 1 and 22.4±25.8 dB for Group 2, with no significant differences (p=0.402). The recovery rate according to Siegel’s criteria were 34/70 (48.6%) and 18/36 (50.0%) respectively, with no significant differences (p=0.889). The degree of pain after ITSI were 1.51±1.06 and 3.92±1.63 for Group 1 and 2, respectively, showing significant differences (p＜0.001). Again, there were no significant differences even when accompanying symptoms or severity of initial hearing loss were considered. Conclusion There was no significant difference between efficacy of dexamethasone and methylprednisolone when used as primary therapy. Methylprednisolne caused more severe pain after ITSI, suggesting the choice of dexamethasone. Further studies are needed about the concentration of injected steroid. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(9):441-8
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