Intratympanic methylprednisolone as rescue therapy in sudden sensorineural hearing loss

Abstract

Treatment in sudden sensorineural hearing loss is a contentious issue, today, oral steroids are the most common choice and considered the best treatment option, but the use of intratympanic steroids has become an attractive alternative, especially in cases when systemic therapy fails, or to avoid the side effects of the systemic use of steroids.

Aim: To describe the results of intratympanic methylprednisolone in idiopathic sudden sensorineural hearing loss after failure of oral prednisolone.

Methods: In a prospective study fourteen patients with idiopathic sudden sensorineural hearing loss were treated with intratympanic methylprednisolone after failing in the treatment with systemic steroids. Pretreatment and post-treatment audiometric evaluations including pure tone average (PTA) and speech reception thresholds (SRT) were analyzed.

Results: Ten from 14 patients treated with intra-tympanic methylprednisolone presented with hearing recovery > 20 dB in PTA or 20% in SRT.

Conclusion: Three intratympanic injections of methylprednisolone improved pure-tone average or speech discrimination scores for a subset of sudden hearing loss subjects that failed to benefit from oral steroids.

Figure 1

Recovery after oral corticosteroid therapy.

Figure 2

Recovery ratio following intratympanic corticosteroid therapy and the initial tritonal mean.

Figure 3

Recovery ratio following intratympanic corticosteroid therapy and the time elapsed before starting corticosteroid therapy.

Figure 4

Comparison between recovery and types of treatment.

Figure 5

Comparison between recovery of the SRR after oral and intratympanic corticosteroid therapy