Therapeutic effectiveness over time of intratympanic dexamethasone as salvage treatment of sudden deafness

Abstract

Conclusion: Intratympanic dexamethasone (ITD) within 1 month after initial treatment failure should be utilized as salvage treatment for refractory sudden sensorineural hearing loss (SSNHL).

Objective: To investigate the therapeutic efficacy over time of ITD as salvage treatment in SSNHL.

Materials and methods: We retrospectively reviewed the medical records and audiograms of 99 SSNHL patients who were refractory to 2 weeks of oral steroid treatment, from August 2003 to October 2006. Patients were divided into those receiving no further treatment (control group) and those receiving ITD within 2 weeks (early-ITD), between 2 weeks and 1 month (mid-ITD), and between 1 and 2 months (late-ITD) after initial treatment failure. ITD was performed in the supine position on four separate occasions over the course of 2 weeks. Final assessment of hearing was carried out 3 months after outbreak of SSNHL. Hearing improvement was defined as a > 15 dB decrease in four-tone average (FTA).

Results: Overall hearing improvement was observed in 8 of 50 (16.0%) control patients, 7 of 16 (43.8%) early ITD patients, 6 of 20 (30.0%) mid ITD patients, and 2 of 13 (15.4%) late ITD patients.