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Probability of clinically significant hearing recovery following salvage intratympanic steroids for sudden sensorineural hearing loss in the ‘real world’

Published online by Cambridge University Press:  18 May 2022

L Q Li Open the ORCID record for L Q Li [Opens in a new window]  and
A M D Bennett
L Q Li
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Lauriston Building, Edinburgh, Scotland, UK
A M D Bennett*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Lauriston Building, Edinburgh, Scotland, UK
*
Author for correspondence: Mr A M D Bennett, Department of Otolaryngology, Lauriston Building, Lauriston Place, Edinburgh EH3 9EN, Scotland, UK E-mail: alex.bennett@nhslothian.scot.nhs.uk
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Abstract

Objective

This study aimed to determine the probability of hearing recovery in patients with idiopathic sudden sensorineural hearing loss following salvage intratympanic steroids

Method

A retrospective review of all patients receiving salvage intratympanic steroid injections for idiopathic sudden sensorineural hearing loss was performed (January 2014 to December 2019). Twenty-two patients were identified, of whom 15 met inclusion criteria. Pre- and post-treatment audiograms were compared with the unaffected ear. Hearing recovery was categorised based on American Academy of Otolaryngology Head and Neck Surgery criteria.

Results

Only 1 patient out of 15 (6.7 per cent) made a partial recovery, and the remainder were non-responders. The median duration of time between symptom onset and first salvage intratympanic steroid treatment was 52 days (range, 14–81 days). No adverse reactions were observed.

Conclusion

‘Real world’ patients with idiopathic sudden sensorineural hearing loss present differently to those in the literature. Sudden sensorineural hearing loss should be diagnosed with care and intratympanic steroid injections initiated early if considered appropriate. Patients should make an informed decision on treatment based on prognostic factors and local success rates.

Keywords

SteroidsInjection, IntratympanicHearing Loss, SuddenHearing Loss, SensorineuralAudiometry

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 9 , September 2022 , pp. 831 - 838
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr A M D Bennett takes responsibility for the integrity of the content of the paper

Presented at Winter ENT Scotland Meeting (virtual), 27 November 2020.

References

Chandrasekhar, SS, Tsai Do, BS, Schwartz, SR, Bontempo, LJ, Faucett, EA, Finestone, SA et al. Clinical practice guideline: sudden hearing loss (update). Otolaryngol Neck Surg 2019;161:195–210CrossRefGoogle Scholar
Eisenman, DJ, Arts, HA. Effectiveness of treatment for sudden sensorineural hearing loss. Arch Otolaryngol - Head Neck Surg 2000;126:1161–4CrossRefGoogle ScholarPubMed
Mattox, DE, Simmons, FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463–0CrossRefGoogle ScholarPubMed
Fetterman, BL, Saunders, JE, Luxford, WM. Prognosis and treatment of sudden sensorineural hearing loss. Am J Otol 1996;17:529–6Google ScholarPubMed
Byl, FM. Sudden hearing loss: eight years’ experience and suggested prognostic table. Laryngoscope 1984;94:647–61CrossRefGoogle ScholarPubMed
Chandrasekhar, SS. Intratympanic Dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otol Neurotol 2001;22:18–23CrossRefGoogle ScholarPubMed
Wei, BPC, Stathopoulos, D, O'Leary, S. Steroids for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 2013;(7):CD003998Google Scholar
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;106:772–6CrossRefGoogle ScholarPubMed
Mirian, C, Ovesen, T. Intratympanic vs systemic corticosteroids in first-line treatment of idiopathic sudden sensorineural hearing loss: a systematic review and meta-analysis. JAMA Otolaryngol - Head Neck Surg 2020;146:421–8CrossRefGoogle ScholarPubMed
Qiang, Q, Wu, X, Yang, T, Yang, C, Sun, H. A comparison between systemic and intratympanic steroid therapies as initial therapy for idiopathic sudden sensorineural hearing loss: a meta-analysis. Acta Otolaryngol 2017;137:598–605CrossRefGoogle ScholarPubMed
Spear, SA, Schwartz, SR. Intratympanic steroids for sudden sensorineural hearing loss: a systematic review. Otolaryngol Head Neck Surg 2011;145:534–43CrossRefGoogle ScholarPubMed
Ng, JH, Ho, RCM, Cheong, CSJ, Ng, A, Yuen, HW, Ngo, RYS. Intratympanic steroids as a salvage treatment for sudden sensorineural hearing loss? A meta-analysis. Eur Arch Otorhinolaryngol 2015;272:2777–82CrossRefGoogle ScholarPubMed
Li, H, Feng, G, Wang, H, Feng, Y. Intratympanic steroid therapy as a salvage treatment for sudden sensorineural hearing loss after failure of conventional therapy: a meta-analysis of randomized, controlled trials. Clin Ther 2015;37:178–87CrossRefGoogle ScholarPubMed
Garavello, W, Galluzzi, F, Gaini, RM, Zanetti, D. Intratympanic steroid treatment for sudden deafness. Otol Neurotol 2012;33:724–9CrossRefGoogle ScholarPubMed
Crane, RA, Camilon, M, Nguyen, S, Meyer, TA. Steroids for treatment of sudden sensorineural hearing loss: a meta-analysis of randomized controlled trials. Laryngoscope 2015;125:209–217CrossRefGoogle ScholarPubMed
Barreto, MA de SC, Ledesma, ALL, de Oliveira, CACP, Bahmad, F. Intratympanic corticosteroid for sudden hearing loss: does it really work? Braz J Otorhinolaryngol 2016;82:353–64CrossRefGoogle ScholarPubMed
Lavigne, P, Lavigne, F, Saliba, I. Intratympanic corticosteroids injections: a systematic review of literature. Eur Arch Otorhinolaryngol 2016;273:2271–8CrossRefGoogle ScholarPubMed
Xenellis, J, Papadimitriou, N, Nikolopoulos, T, Maragoudakis, P, Segas, J, Tzagaroulakis, A et al. Intratympanic steroid treatment in idiopathic sudden sensorineural hearing loss: a control study. Otolaryngol - Head Neck Surg 2006;134:940–5CrossRefGoogle ScholarPubMed
Ho, GM, Lin, HC, Shu, MT, Yang, CC, Tsai, HT. Effectiveness of intratympanic dexamethasone injection in sudden-deafness patients as salvage treatment. Laryngoscope 2004;114:1184–9Google ScholarPubMed
Plontke, SK, Löwenheim, H, Mertens, J, Engel, C, Meisner, C, Weidner, A et al. Randomized, double blind, placebo controlled trial on the safety and efficacy of continuous intratympanic dexamethasone delivered via a round window catheter for severe to profound sudden idiopathic sensorineural hearing loss after failure of systemic therapy. Laryngoscope 2009;119:359–69CrossRefGoogle Scholar
Scottish government | Lothian. https://statistics.gov.scot/atlas/resource?uri=http%3A%2F%2Fstatistics.gov.scot%2Fid%2Fstatistical-geography%2FS08000024 [6 November 2019]Google Scholar
Parnes, LS, Sun, A-H, Freeman, DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope 1999;109:1–17CrossRefGoogle ScholarPubMed
Bird, PA, Begg, EJ, Zhang, M, Keast, AT, Murray, DP, Balkany, TJ. Intratympanic versus intravenous delivery of methylprednisolone to cochlear perilymph. Otol Neurotol 2007;28:1124–30CrossRefGoogle ScholarPubMed
Dispenza, F, Amodio, E, De Stefano, A, Gallina, S, Marchese, D, Mathur, N et al. Treatment of sudden sensorineural hearing loss with transtympanic injection of steroids as single therapy: a randomized clinical study. Eur Arch Otorhinolaryngol 2011;268:1273–8CrossRefGoogle ScholarPubMed
Russell, CD, Millar, JE, Kenneth Baillie, J. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet 2020;395:473–5CrossRefGoogle Scholar
Liebau, A, Pogorzelski, O, Salt, AN, Plontke, SK. Hearing changes after intratympanically applied steroids for primary therapy of sudden hearing loss: A meta-analysis using mathematical simulations of drug delivery protocols. Otol Neurotol 2017;38:19–30CrossRefGoogle ScholarPubMed
Hamid, M, Trune, D. Issues, indications, and controversies regarding intratympanic steroid perfusion. Curr Opin Otolaryngol Head Neck Surg 2008;16:434–40CrossRefGoogle ScholarPubMed
LG, Siegel. The treatment of idiopathic sudden sensorineural hearing loss. Otolaryngol Clin North Am 1975;8:467–73Google Scholar