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Intratympanic steroid use for idiopathic sudden sensorineural hearing loss: current otolaryngology practice in Germany and Austria

  • Otology
  • Published:
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Abstract

Aims

The frequency of the use of intratympanic steroids (ITS) as a treatment for idiopathic sudden sensorineural hearing loss (ISSNHL) in Europe is still unknown and remains a contentious issue amongst otolaryngologists. We undertook a survey of otolaryngologists in Germany and Austria to establish if there is any professional consensus with which to form a protocol for its use.

Methods

A survey of 21 questions was distributed electronically to otolaryngologists in Germany and Austria and data on demographics, indications for intratympanic treatment, procedure, follow-up, and outcomes were analysed.

Results

We received 908 responses. 49.1% of otolaryngologists used ITS for ISSNHL. Of those otolaryngologists who use ITS, 73.7% do not use it as primary treatment. 20.6% use ITS in conjunction with oral steroids for primary treatment and only 5.8% use ITS as monotherapy for primary treatment. 90.5% use ITS as salvage therapy. 81.1% do not consider the use of ITS after 2 weeks from the onset of symptoms. 8.3% used a tympanostomy tube and while the most commonly used steroid was dexamethasone at a concentration of 4 mg/ml (61%), a wide variety or other steroids and concentrations were used.

Conclusions

This survey illustrates wide variation of current practice of intratympanic corticosteroid injection for ISSHL in Germany and Austria. In the absence of high-level evidence, knowing what current practice is allows clinicians to assess what they do against what their colleagues are doing, and if they do something very different, make them question their practice. Moreover, the obtained data will help to direct future clinical trials with the aim to compare the outcomes of more commonly used protocols.

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Acknowledgements

We would like to thank the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (http://www.hno.org) and the Austrian Society of Oto-Rhino-Laryngology, Head and Neck Surgery (http://www.hno.at).

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Authors and Affiliations

  1. Head and Neck Centre, University College London Hospitals NHS Trust, Euston Road, London, NW1 2PG, UK

    L. Sutton & M. Lechner

  2. UCL Cancer Institute, University College London, 72 Huntley Street, London, WC1E 6DD, UK

    L. Sutton & M. Lechner

  3. Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Innsbruck, Anichstr., Innsbruck, Austria

    V. Schartinger, C. Url, J. Schmutzhard, D. Lechner, H. Riechelmann & M. Lechner

  4. Lanarkshire, Scotland, UK

    C. Kavasogullari

  5. Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S5 7AT, UK

    J. S. Sandhu

  6. Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Trust, 330 Grays Inn Road, London, WC1X 8DA, UK

    A. Shaida & M. Lechner

  7. Department of Otorhinolaryngology, University Hospital of Freiburg, Breisacher Str., Freiburg, Germany

    R. Laszig

  8. ENT Clinic, Maienbeeck, Bad Bramstedt, Germany

    J. Loehler

  9. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Halle, Ernst-Grube-Str., Halle, Germany

    S. Plontke

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  1. L. Sutton
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Correspondence to M. Lechner.

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Conflict of interest

L. Sutton declares that he has no conflict of interest. V. Schartinger declares that he has no conflict of interest. C. Url declares that he has no conflict of interest. J. Schmutzhard declares that he has no conflict of interest. D. Lechner declares that she has no conflict of interest. C. Kavasogullari declares that he has no conflict of interest. J.S. Sandhu declares that he has no conflict of interest. A. Shaida declares that he has no conflict of interest. R. Laszig declares that he has no conflict of interest. J. Loehler declares that he has no conflict of interest. S. Plontke declares that he has no conflict of interest. H. Riechelmann declares that he has no conflict of interest. M. Lechner declares that he has no conflict of interest.

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Sutton, L., Schartinger, V., Url, C. et al. Intratympanic steroid use for idiopathic sudden sensorineural hearing loss: current otolaryngology practice in Germany and Austria. Eur Arch Otorhinolaryngol 275, 1103–1110 (2018). https://doi.org/10.1007/s00405-018-4958-8

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