Intratympanic steroids for inner ear disorders: a review

Abstract

Background/aim: The use of intratympanic steroids (ITS) has proliferated over the past 10-15 years to include treatments for inner ear disorders, like Ménière's Disease (MD) and sudden sensorineural hearing loss (SSNHL). The aim of this study was to review the clinical trials of ITS for inner ear disorders.

Methods: PubMed and Ovid Medline databases were searched from 1966 to present for clinical trials on ITS in the treatment of MD and SSNHL. Studies were evaluated based on comparability and internal and external validity.

Results: Thirty-eight studies were identified in total, 13 studies on MD and 25 studies on SSNHL. Most studies lacked placebo controls. Only 3 studies were double-blinded randomized prospective trials. Overall, there were heterogeneous steroid doses, treatment protocols, previous treatments, and definitions of disease and improvement.

Conclusion: There are no good studies on ITS that meet the criteria of comparability, internal validity, and external validity. It is difficult to compare studies due to the heterogeneous nature of the data. More rigorously designed studies are required to determine the efficacy of this treatment, the optimal steroid to use, and the best treatment regimen.