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. 2016 Jun 20:5:111.
doi: 10.4103/2277-9175.184277. eCollection 2016.

Intratympanic dexamethasone injection vs methylprednisolone for the treatment of refractory sudden sensorineural hearing loss

Nezamoddin Berjis  1 , Saeed Soheilipour  1 , Alireza Musavi  1 , Seyed Mostafa Hashemi  1
Affiliations

Intratympanic dexamethasone injection vs methylprednisolone for the treatment of refractory sudden sensorineural hearing loss

Nezamoddin Berjis et al. Adv Biomed Res. .

Abstract

Background: During the past years various drugs have been used for sudden sensorineural hearing loss (SSNHL) treatment including steroids that are shown to be beneficial. Directed delivery of high doses of steroids into the inner ear is suggested for its potential and known as intratympanic steroids therapy (IST). Despite the use of dexamethasone and methylprednisolone as the traditional treatments, there are still debates about the optimal dosage, preferred drug, and the route of administration.

Materials and methods: We performed a randomized clinical trial study in which 50 patients suffering from SSNHL and resistant to standard therapy were employed. Each patient took 0.5 ml methylprednisolone (40 mg/mg) along with bicarbonate or dexamethasone (4 mg/mL) through direct intratympanic injection. This method was performed and scheduled once every 2 days for three times only for the dexamethasone receiving group. Hearing test was carried out and the results were analyzed according to a four-frequency (0.5, 1.0, 2.0, 3.0 kHz) pure tone average (PTA) and Siegel's criteria.

Results: According to Siegel's criteria, three out of 25 (12%) dexamethasone receiving patients were healed in 1 and 4 (16%), 9 (32%) were respectively recovered in Siegel's criteria 2, 3, and 9 (32%) showed no recovery. In the group receiving methylprednisolone, recovery was found in 6 (24%), 8 (32%), 7 (28%) patients in the Siegel's criteria 1, 2, 3, respectively, and in 4 (16%) patients no recovery was recorded. In methylprednisolone group, hearing was significantly improved compared to the dexamethasone group (P < 0.05). The general hearing improvement rate was 84% in methylprednisolone receiving patients showing a significantly higher improvement than 64% in the dexamethasone group.

Conclusions: Topical intratympanic treatment with methylprednisolone is safe and an effective treatment approach for those SSNHL cases that are refractory to the common therapies by Dexamethasone.

Keywords: Dexamethasone; intratympanic injection; methylprednisolone; steroid therapy; sudden sensorineural hearing loss.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Hearing improvement based on Siegel's criteria in Dexamethasone and Methylprednisolone groups
See this image and copyright information in PMC

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References

    1. Haberkamp TJ, Tanyeri HM. Management of idiopathic sudden sensorineural hearing loss. Am J Otol. 1999;20:587–95. - PubMed
    1. Gianoli GJ, Li JC. Transtympanic steroid for treatment of sudden hearing loss. Otolaryngol Head Neck Surg. 2001;125:142–6. - PubMed
    1. Rauch SD. Intratympanic steroids for sensorineural hearing loss. Otolaryngol Clin North Am. 2004;37:1061–74. - PubMed
    1. Wilson WR, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double blind clinical study. Arch Otolaryngol. 1980;106:772–6. - PubMed
    1. Shimmer BP, Parker KL. Adrenocorticotrophic hormone; adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones. In: Hardman JG, Limbird LE, Molinoff PB, Gilman AG, editors. Goodman and Gilman's the pharmacological basis of the therapeutics. 9th ed. New York, NY: McGraw-Hill; 1996. p. 1459.