The Outcome of Prompt Concomitant Single-Dose High-Concentration Intratympanic and Tapered Low-Dose Oral Systemic Corticosteroid Treatment for Sudden Deafness.

Abstract

OBJECTIVES:

To investigate the efficacy of prompt concomitant corticosteroid treatment with single application of high-concentration intratympanic (IT) dexamethasone and tapered low-dose systemic methylprednisolone of an idiopathic sudden sensorineural hearing loss (ISSNHL).

MATERIALS AND METHODS:

Between September 2017 and September 2019, 86 adult patients met the criteria for the diagnosis of ISSNHL at baseline evaluation. The patients received immediate concomitant treatment with single high-concentration (24 mg/mL) IT dexamethasone and low-dose (48 mg) oral methylprednisolone for 1 week followed by tapered doses. Improvement in pure-tone average (PTA) and word recognition score (WRS) was determined after 1 and 6 months.

RESULTS:

A total of 63 patients met the requirements for the analysis. PTA improved in 71% and WRS improved in 59% of patients with ISSNHL. PTA and WRS were statistically significantly different at different time points during the intervention (p<0.0005). Hearing improved in all measured frequencies from 125 to 8000 Hz until the second follow-up. In 65.4% of patients with tinnitus, the WRS has improved compared with 27.3% without tinnitus (p<0.05). In 69.2% of patients without vertigo, the WRS has improved compared with 41.7% with vertigo (p<0.05).

CONCLUSION:

Prompt concomitant single high-concentration IT and low-dose systemic corticosteroid treatment is efficient in recovering hearing loss and speech discrimination in ISSNHL. Tinnitus positively predicts hearing outcome. Vertigo negatively predicts speech discrimination recovery.

• Authors: Špela Kordiš, Domen Vozel, Manja Hribar, Nina Božanić Urbančič, Saba Battelino
• Journal: The journal of international advanced otology (J Int Adv Otol) Vol. 16 Issue 2 Pg. 201-206 (Aug 2020) ISSN: 2148-3817 [Electronic] Turkey
• PMID: 32784158 (Publication Type: Journal Article)

Chemical References

• Glucocorticoids
• Dexamethasone
• Methylprednisolone

Topics

• Audiometry, Pure-Tone
• Dexamethasone (administration & dosage)
• Drug Therapy, Combination
• Female
• Glucocorticoids (administration & dosage)
• Hearing (drug effects)
• Hearing Loss, Sudden (drug therapy)
• Humans
• Injection, Intratympanic
• Male
• Methylprednisolone (administration & dosage)
• Middle Aged
• Prospective Studies
• Speech Perception
• Treatment Outcome