The prognosis of idiopathic
sudden hearing loss depends on its severity; acute complete
deafness, for example, has a particularly bad prognosis. The treatment of acute
deafness is based on a systemic application of
corticosteroids.
Corticoid concentrations in the cochlea are higher after transtympanic application in comparison to systemic application. We therefore investigated whether an additional transtympanic
corticoid therapy gives an advantage over systemic standard
therapy. We report on 27 patients with sudden idiopathic profound
hearing loss or
deafness who were treated in the Department of Otorhinolaryngology, University of Essen, Germany. Fourteen patients were treated with a rheologic infusion
therapy with systemic
prednisolone. Thirteen patients were treated additionally with
methylprednisolone (
Urbason) transtympanically through a ventilation tube. In the first group of patients who were treated with infusion
therapy and
corticoids systemically, three patients had good recovery of hearing. Another five patients had a partial recovery of hearing. The average hearing gain from 0.5-4 kHz was 15 dB. In the group of patients who were treated additionally with local
corticoids, two patients reported a good recovery of hearing and another two patients only had a partial recovery of hearing. The average hearing gain in the above-mentioned frequency range was 11 dB. In our patients the additional transtympanic application of
corticoids did not result in a significantly improved recovery of hearing in comparison to the patients treated with the standard
therapy alone.