Role of Intratympanic Steroids in the Management of Idiopathic Sudden Sensori-Neural Hearing Loss

ABSTRACT

Background: To assess the outcomes of intratympanic steroids in the management of idiopathic sudden sensori-neural hearing loss. Study Design: Retrospective study. Setting: tertiary care medical centre. Methods: A total of 56patients with idiopathic sudden sensorineural hearing loss were included in our study. They received 4 doses of 0.3- 0.5ml of( 40 mg/mL ) of methylprednisolone injected into the middle ear with a gap of four days in between the doses. Pre- and post-injection hearing evaluation was done to determine overall success, morbidity, and prognostic factors. Patient variables as they related to recovery were studied and included patient’s age, time to onset of therapy, severity of hearing loss, and presence of associated symptoms. Results: A total of 56 patients were included in our study of which unilateral cases were 52 and bilateral cases were 4. Subjectively 38 patients reported improvement in hearing after the therapy while objectively we found 44 ears(74%) ,41 patients had improvement. The mean PTA pre ITS (intratympanic steroid) was 58.7 dB and after ITS it was 30.3dB. Thus mean PTA improved by 28.4 dB. Conclusion: Intratympanic steroids can be offered as a first line therapy for idiopathic sudden sensorineural hearing loss as it is minimally invasive, and can be performed as an office based procedure with no systemic side effects. No major complications has been reported in our study and results have been satisfactory.