Intratympanic injection in sudden sensorineural hearing loss

The aim of this study was to evaluate intratympanic corticosteroid injection in cases with idiopathic sudden sensorineural hearing loss [SSNHL]. Sixty patients with SSNHL were included in this study, 35 were females and 25 were males. The age ranged from 14 to 67 years old. The hearing loss was graded into mild, moderate, severe and profound. The patients were classified into 3 groups according to the treatment modality, group I did not receive corticosteroid therapy and included 10 patients, group II received systemic corticosteroid therapy and included 13 patients and group III received intratympanic corticosteroid therapy and included 37 patients. In group I, 30% of patients showed improvement. In group II, 46% of patients showed improvement. In group III, 86% showed improvement of hearing. Intratympanic corticosteroid therapy for SSNHL has a better success rate than systemic corticosteroid therapy and control patients with no treatment. It has a low incidence of complications. Patients with mild and moderate hearing loss have a better prognosis than patients with severe and profound hearing loss

ENG profile in auditory neuropathy

Twelve patients with auditory neuropathy aged 11 - 34 years were subjected to ENG test battery including gaze, random saccades, pursuit, optokinetic, positional and bithermal water caloric tests. Twenty age and gender matched normal subjects were included as a control group. None of the 12 patients had history of vertigo or unsteadiness. Neither gaze evoked nor positional nystagmus was recorded in any patient. 7 patients out of 12 had abnormal gain of pursuit tracking and optokinetic nystagmus [< 0.7] and 2 out of the 7 had abnormal fixation index [> 50%]. Moreover, the average slow phase velocity of the total caloric response in auditory neuropathy patients showed statistically significant reduced values as compared to those obtained from the control group, however none of the 12 patients had total caloric response < 22 degrees/second. These results are suggestive of a potential peripheral vestibular dysfunction in addition to central vestibular dysfunction mainly at the level of brainstem