Skip to main content
SpringerLink
Log in

Evaluation of Sudden Sensory-Neural Hearing Loss Patients Treated with Systemic Steroids with Additional Intratympanic Dexamethasone Injection in Different Intervals; a Clinical Trial Study

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Sudden Sensory-Neural Hearing Loss (SSNHL) is one of the most important otologic emergency. Although adding intratympanic (IT) steroids to systematic steroid may be beneficial, the exact timing of the IT injections to provide the best response needs further investigations. To compare different protocols in treting sudden sensorineural hearing loss. We performed a clinical trial study on 120 patients from October 2021 to February 2022. All patients were prescribed 1 mg/Kg daily oral prednisolone. After randomization to three groups, the control group received standard twice a week IT steroid injections in 12 days (four total injections) while intervention groups 1 and 2 received once and twice a day IT injections for ten days. Audiometric study repeated 10–14 days after the last injection and assessed based on the Siegel criteria. We used the Chi-Square, Analysis of Variance (ANOVA), Kruskal–Wallis’s tests where appropriate. The most clinical improvement was found in the standard treatment group, and group-2 had the greatest number of patients with no improvement; however, no overall significant difference was observed among the three groups (p-value: 0.066; Pearson Chi-Square). Less frequent IT injections in patients already on systemic steroids provide similar results to more frequent injections.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

All data generated or analysed during this study are included in this article. Further enquiries can be directed to the corresponding author.

References

  1. Shewel Y, Asal SI (2020) Intratympanic injection of dexamethasone 4 mg/mL versus 10 mg/mL for management of idiopathic sudden sensorineural hearing loss. Egypt J Otolaryngol 36(1):1–6

    Article  Google Scholar 

  2. Chandrasekhar SS, Tsai Do BS, Schwartz SR et al (2019) Clinical practice guideline: sudden hearing loss (update). Otolaryngol Head Neck Surg 161:S1-45

    PubMed  Google Scholar 

  3. Berjis N, Soheilipour S, Musavi A et al (2016) Intratympanic dexamethasone injection vs methylprednisolone for the treatment of refractory sudden sensorineural hearing loss. Adv Biomed Res 5:111

    Article  PubMed  PubMed Central  Google Scholar 

  4. Jung DJ, Park JH, Jang JH et al (2016) The efficacy of combination therapy for idiopathic sudden sensorineural hearing loss. Laryngoscope 126(8):1871–1876

    Article  CAS  PubMed  Google Scholar 

  5. Shirwany NA, Seidman MD, Tang W (1998) Effect of transtympanic injection of steroids on cochlear blood flow, auditory sensitivity, and histology in the guinea pig. Am J Otol 19(2):230–235

    CAS  PubMed  Google Scholar 

  6. Lee JJ, Jang JH, Choo OS et al (2018) Steroid intracochlear distribution differs by administration method: systemic versus intratympanic injection. Laryngoscope 128(1):189–194

    Article  CAS  PubMed  Google Scholar 

  7. Hargunani CA, Kempton JB, DeGagne JM et al (2006) Intratympanic injection of dexamethasone: time course of inner ear distribution and conversion to its active form. Otol Neurotol 27(4):564–569

    PubMed  Google Scholar 

  8. Suzuki H, Koizumi H, Ohkubo J-i et al (2016) Hearing outcome does not depend on the interval of intratympanic steroid administration in idiopathic sudden sensorineural hearing loss. Eur Archiv Oto-Rhino-Laryngol 273(10):3101–7

    Article  Google Scholar 

  9. Shewel Y, Asal S (2020) Intratympanic injection of dexamethasone 4 mg/mL versus 10 mg/mL for management of idiopathic sudden sensorineural hearing loss. Egypt J Otolaryngol. https://doi.org/10.1186/s43163-020-00003-7

    Article  Google Scholar 

  10. Chou YF, Chen PR, Kuo IJ et al (2013) Comparison of intermittent intratympanic steroid injection and near-continual transtympanic steroid perfusion as salvage treatments for sudden sensorineural hearing loss. Laryngoscope 123(9):2264–2269

    Article  PubMed  Google Scholar 

  11. Topf M, Hsu D, Adams D et al (2017) Rate of tympanic membrane perforation after intratympanic steroid injection. Am J Otolaryngol 38(1):21–25

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Sinus and Surgical Endoscopic Research Center, Department of Otorhinolaryngology, School of Medicine, Mashhad University of Medical Sciences, 9176717671, Mashhad, Iran

    Navid Nourizadeh, Naeeme Rezaiee, Mohsen Rajati & Mohamad Reza Afzalzadeh

  2. Otolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Sasan Dabiri

  3. Mashhad University of Medical Sciences, Mashhad, Iran

    Kimia Hasanabadi

Authors
  1. Navid Nourizadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Naeeme Rezaiee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohsen Rajati
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sasan Dabiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mohamad Reza Afzalzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kimia Hasanabadi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohamad Reza Afzalzadeh.

Ethics declarations

Conflict of interest

None.

Ethical Approval

This study protocol was reviewed and approved by the Ethical Committee of Approval Number: REC.1399.232. Written informed consent was obtained for participation in this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 13 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nourizadeh, N., Rezaiee, N., Rajati, M. et al. Evaluation of Sudden Sensory-Neural Hearing Loss Patients Treated with Systemic Steroids with Additional Intratympanic Dexamethasone Injection in Different Intervals; a Clinical Trial Study. Indian J Otolaryngol Head Neck Surg 75 (Suppl 1), 568–573 (2023). https://doi.org/10.1007/s12070-023-03641-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-023-03641-4

Keywords

Search

Navigation