Intratympanic steroid injection as treatment for sudden unilateral sensorineural hearing loss

Introduction:

Patients with acute unilateral hearing loss can be offered an intratympanic steroid injection (ITC) besides a systemic steroid therapy. ITC is frequently used as salvage treatment in patients with a lack of recovery after the primary systemic steroid therapy (PSS). It can also be preferred when side effects of PSS could lead to disorders of preexisting diseases.

Methods:

We retrospectively analyzed data of 74 cases with acute unilateral hearing loss (m/f = 51/23; 16 – 85 years) who received ITC at the Department of Otorhinolaryngology of Ulm University Medical Center from 2006 to 2016. 91% of the patients received a PSS beforehand. The average preinterventional hearing loss was 49dB. The first ITC was carried out within 20 days after the incidence in 54% of the patients.

Results:

Almost 30% of the patients achieved an improvement of the hearing threshold level of ≥10dB in the postinterventional tone audiogram, whereas only 4% of the patients achieved an improvement of ≥30dB (medium observation period: 97 days). 8% of the patients showed a decrease of the medium hearing threshold level of ≥10dB in the postinterventional tone audiogram, whereas the maximum was 13dB. Initiation of the therapy within ten days of the occurrence of the hearing loss led to significantly better results compared to a later initiation of the therapy. Complications like short-time vertigo and hypotension led to hospitalization of only one patient.

Conclusion:

ITC is a therapeutic option with low side effects for acute hearing loss, that can be offered also to patients with contraindications for a PSS. It should be carried out within the first ten days after the incidence, particularly after failure of PSS.

Publication History

Publication Date:
18 April 2018 (online)