Treatment of sudden sensorineural hearing loss with transtympanic injection of steroids as single therapy: a randomized clinical study.

摘要

The aim of this study was to verify the efficacyudand the safety of transtympanic dexamethasone to treatudsudden sensorineural hearing loss as first and single drugudmethod. Considering ethical implication of performing audmininvasive procedure on middle ear, we matched suchudproposed treatment with systemic prednisone administrationudthat represents the widest adopted protocol. Randomizedudprospective study was conducted. The inclusionudcriterion was a sudden sensorineural hearing loss of at leastud30 dB across three contiguous frequencies over a period ofud24 h. Group A received transtympanic steroid injections;udGroup B received oral administration of steroids. 25udpatients were treated with transtympanic therapy whereasud21 underwent systemic treatment. The mean of initial PTAudwas 59 dB for the whole series: 65 dB for group A andud51 dB for group B. The recovery better than 10 dB wasudobtained in 80% of patients of group A and in 17 81% ofudpatients of group B, with a total of 80.5%. The mean relativeudgain in PTA was 41.16% in the group A and 44.7% inudthe group B. In the frequencies tested (0.5, 1, 2, and 4 kHz)udPTA improvements after transtympanic treatment wereudhigher than after systemic treatment, but these differencesudwere not statistically significant (P = 0.61). Both transtympanicudand systemic treatment had similar clinicaludrecovery times. This prospective randomized clinical studyudshowed good result in terms of hearing recovery, betterudthan the expected results of the simple observation withoutudtreatment. We can consider transtympanic administrationudas a first line treatment, because of the statistical analysisudconfirmed similar results with systemic therapy, reducingudpossible side effects of systemic drug administration. Theuddelay of treatment does not influence the outcome, allowingudtreating patients within 10 days of onset.