Intratympanic steroid use for idiopathic sudden sensorineural hearing loss: current otolaryngology practice in Germany and Austria
- 215 Downloads
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.
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.
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.
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.
KeywordsAdult Hearing loss Sudden hearing loss Intratympanic Steroids
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).
Compliance with ethical standards
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.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 12.Wei BP, Stathopoulos D, O’Leary S. Steroids for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev. 2013;(7):CD003998. https://doi.org/10.1002/14651858.CD003998.pub3
- 22.Battaglia A, Lualhati A, Lin H, Burchette R, Cueva R (2014) A prospective, multi-centered study of the treatment of idiopathic sudden sensorineural hearing loss with combination therapy versus high-dose prednisone alone: a 139 patient follow-up. Otol Neurotol 35(6):1091–1098CrossRefPubMedGoogle Scholar
- 24.Siegel LG (1975) The treatment of idiopathic sudden sensorineural hearing loss. Otolarynol Clin North Am 8(2):467–473Google Scholar
- 27.Liebau A, Pogorzelski P, Salt AN, Zenner HP, Plontke SK (2017) Dependence of hearing changes after intratympanically applied steroids for primary therapy of sudden hearing loss: a meta-analysis using mathematical simulations of clinical drug delivery protocols. Otol Neurotol 38(1):19–30CrossRefPubMedPubMedCentralGoogle Scholar
- 33.Kosyakov S, Atanesyan A, Gunenkov A, Ashkhatunyan E, Kurlova A (2011) Intratympanic steroids for sudden sensorineural hearing loss. J Int Adv Otol 7(3):323–332Google Scholar