Intratympanic dexamethasone in diabetic and hypertensive patients with sudden sensorineural hearing loss

ABSTRACT

Systemic steroid therapy has been considered a mainstay for treatment of idiopathic sudden sensorineural hearing loss [ISSNHL], specially among those who suspect a viral etiology. Unfortunately, some patients are poor candidates for systemic steroids. The aim of the present study is to evaluate the efficacy of intratympanic dexamethasone injection for diabetic and hypertensive patients with SSNHL in whom systemic steroid therapy is hazardous. This study was undertaken prospectively on 26 diabetic and hypertensive patients with unilateral moderately severe and severe SSNHL in whom there was a history of a recent upper respiratory tract infection. The patients were 14 men [53.8%] and 12 women I with an age range 43-68 years. Under local anaesthesia. 0.5 ml of dexamethasone [24 mg/mi] was injected in the tympanic cavity. injection was performed on three separate occasions over 10 days. Hearing was assessed by pure-tone and speech audiometry immediately before, twice weekly during therapy and within 3 weeks after therapy was discontinued. Pure-tone average [500, 1000 and 2000Hz] improved in 15 patients [57, 7%]. 7 patients [27%] recovered to normal hearing threshold levels 5 patients [19.2%] improved to a degree of mild hearing loss and3 patients [11.5%] improved to a degree of moderate hearing loss. A hearing recovery rate of 57.7% in ISSNHL could be considered a good and encouraging response rate in a group of patients who an not tolerate systemic steroid therapy and may be considered beyond therapeutic reach