Skip to main content

Advertisement

SpringerLink
Log in

Postauricular injection of methylprednisolone sodium succinate as a salvage treatment for refractory sudden sensorineural hearing loss

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Postauricular steroid administration has been popular for treating sudden sensorineural hearing loss. However, there are few reports on its use in patients with refractory sudden sensorineural hearing loss (RSSNHL).

Aims

The objective of this study was to investigate the therapeutic efficacy of postauricular steroid injection as a salvage treatment for RSSNHL patients.

Methods

This retrospective study enrolled 63 RSSNHL patients between January 2016 and January 2019. Thirty-three patients of them who have been divided into the treatment group received postauricular methylprednisolone sodium succinate injection. The remaining 30 patients who formed the control group did not receive any steroid as a salvage therapy. Improvements in hearing were evaluated between pre-salvage therapy and 3 months follow-up after salvage therapy.

Results

The median hearing gain in PTA was 9.88 dB HL (quartile range 7.58, 18.65) in the treatment group and 0.90 dB HL (quartile range 0.00, 4.90) in the control group (P<0.01). According to the criteria of Furuhashi, the total percentage for effective prognosis was 48.48% (16/33) in the treatment group and 10.00% (3/30) in the control group (P<0.01). The time interval from onset to study entry was significantly and independently associated with the prognosis for RSSNHL patients (P< 0.01).

Conclusions

The present findings suggest that postauricular corticosteroid administration as a salvage treatment demonstrated better results than no treatment for RSSNHL patients. The time interval from onset to study entry was mainly the prognostic factor for RSSNHL patients. It is therefore considered that postauricular corticosteroid administration may be used as a salvage therapy for RSSNHL patients.

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

Fig. 1

Similar content being viewed by others

Availability of data and materials

The data and material are available.

References

  1. Stachler RJ, Chandrasekhar SS, Archer SM et al (2012) Clinical practice guideline: sudden hearing loss. Otolaryngology-head and neck surgery: Official Journal of American Academy of Otolaryngology-Head and Neck Surgery 146:S1–35. https://doi.org/10.1177/0194599812436449

  2. Rauch SD (2004) Intratympanic steroids for sensorineural hearing loss. Otolaryngol Clin North Am 37:1061–1074. https://doi.org/10.1016/j.otc.2004.04.004

    Article  PubMed  Google Scholar 

  3. Hunchaisri N, Chantapant S, Srinangyam N (2010) Intratympanic dexamethasone for refractory sudden sensorineural hearing loss. J Med Assoc Thail = Chotmaihet thangphaet 93:1406–1414

  4. Ahn JH, Han MW, Kim JH et al (2008) Therapeutic effectiveness over time of intratympanic dexamethasone as salvage treatment of sudden deafness. Acta Otolaryngol 128:128–131. https://doi.org/10.1080/00016480701477602

    Article  CAS  PubMed  Google Scholar 

  5. Niedermeyer HP, Zahneisen G, Luppa P et al (2003) Cortisol levels in the human perilymph after intravenous administration of prednisolone. Audiol Neurootol 8:316–321. https://doi.org/10.1159/000073516

    Article  CAS  PubMed  Google Scholar 

  6. Li L, Ren J, Yin T, Lui W (2013) Intratympanic dexamethasone perfusion versus injection for treatment of refractory sudden sensorineural hearing loss. European archives of oto-rhino-laryngology: Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 270:861–867. https://doi.org/10.1007/s00405-012-2061-0

  7. Erdur O, Kayhan FT, Cirik AA (2014) Effectiveness of intratympanic dexamethasone for refractory sudden sensorineural hearing loss. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 271:1431–1436. https://doi.org/10.1007/s00405-013-2594-x

  8. Li X, Zhang XY, Wang QJ, Wang DY (2015) Efficacy of methylprednisolone sodium succinate for injection (postotic injection) on the auditory threshold and speech recognition rate of sudden deafness patients. Int J Clin Exp Med 8:14110–14114

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Liu Y, Chen Q, Xu Y (2020) Research progress in refractory sudden hearing loss: steroid therapy. J Int Med Res 48:300060519889426. https://doi.org/10.1177/0300060519889426

    Article  PubMed  Google Scholar 

  10. Furuhashi A, Matsuda K, Asahi K, Nakashima T (2002) Sudden deafness: long-term follow-up and recurrence. Clin Otolaryngol Allied Sci 27:458–463. https://doi.org/10.1046/j.1365-2273.2002.00612.x

    Article  CAS  PubMed  Google Scholar 

  11. Si Y, Jiang HL, Chen YB et al (2018) Round window niche drilling with intratympanic steroid is a salvage therapy of sudden hearing loss. Audiol Neurootol 23:309–315. https://doi.org/10.1159/000493086

    Article  CAS  PubMed  Google Scholar 

  12. Song J, Zhang L, Chen Y (2018) Analysis of the treatment effects of refractory sudden total frequency deafness with steroid from different topical administration routes. Lin chuang er bi yan hou tou jing wai ke za zhi. Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery 32:1897–1899. https://doi.org/10.13201/j.issn.1001-1781.2018.24.012

  13. Zou J (2015) Postaurical injection is a systemic delivery supported by symmetric distribution of Gd-DOTA in both the ipsilateral and contralateral ears. J Otol 10:136–142. https://doi.org/10.1016/j.joto.2016.01.005

    Article  PubMed  Google Scholar 

  14. Li J, Yu L, Xia R et al (2013) Postauricular hypodermic injection to treat inner ear disorders: experimental feasibility study using magnetic resonance imaging and pharmacokinetic comparison. J Laryngol Otol 127:239–245. https://doi.org/10.1017/s0022215113000017

    Article  CAS  PubMed  Google Scholar 

  15. Wang Y, Han L, Diao T et al (2018) A comparison of systemic and local dexamethasone administration: from perilymph/cochlea concentration to cochlear distribution. Hear Res 370:1–10. https://doi.org/10.1016/j.heares.2018.09.002

    Article  CAS  PubMed  Google Scholar 

  16. Cros O, Knutsson H, Andersson M et al (2016) Determination of the mastoid surface area and volume based on micro-CT scanning of human temporal bones. Geometrical parameters depend on scanning resolutions. Hear Res 340:127–134. https://doi.org/10.1016/j.heares.2015.12.005

    Article  PubMed  Google Scholar 

  17. Yang XQ, Yu LS, Ma X (2007) Postaurical injection of compound betamethasone to treat the intractable low-frequency sensorineural hearing loss. Zhonghua er bi yan hou tou jing wai ke za zhi. Chinese Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery 42:814–816

  18. Zhang TY, Shang XL, Xie YX et al (2018) The effects of postauricular injection of methylprednisolone on medium-high frequency sudden hearing loss. Lin chuang er bi yan hou tou jing wai ke za zhi. Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery 32:537–540. https://doi.org/10.13201/j.issn.1001-1781.2018.07.015

  19. Zhu WY, Gao ZW, Qi H et al (2019) Analysis of prognostic factors in patients with refractory sudden sensorineural hearing loss. Lin chuang er bi yan hou tou jing wai ke za zhi. Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery 33:532–536. https://doi.org/10.13201/j.issn.1001-1781.2019.06.014

  20. Wang X, Liu XD, Zhao B et al (2018) Treatment of sudden deafness with type 2 diabetesmellitus by post-auricular subperiosteal injection of methylprednisolone. Lin chuang er bi yan hou tou jing wai ke za zhi. Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery 32:1719–1722. https://doi.org/10.13201/j.issn.1001-1781.2018.22.009

Download references

Acknowledgements

The authors would like to thank Mr. Jian-Bin Sun (Hearing Testing Centre, the First People’s Hospital of Huzhou, Zhejiang, China) for the technical assistance in auditory function testing.

Author information

Authors and Affiliations

  1. Department of Otolaryngology, the First Affiliated Hospital of Huzhou University, the First People’s Hospital of Huzhou, Huzhou, 313000, Zhejiang, China

    Gang Ren, Jue Xu, Longjiang Lan, Bingliang Ma & Qi Zhang

Authors
  1. Gang Ren
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jue Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Longjiang Lan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bingliang Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qi Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The medical records of patients were collated by Jue XU. The postauricular injection was performed by Gang Ren. The auditory function was measured by Longjiang Lan. Statistical analyses were performed by Bingliang Ma. Qi Zhang was responsible for designing the investigation and writing of the manuscript. All the authors reviewed and proved the manuscript.

Corresponding author

Correspondence to Qi Zhang.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent about participating in the study and publication of manuscript was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ren, G., Xu, J., Lan, L. et al. Postauricular injection of methylprednisolone sodium succinate as a salvage treatment for refractory sudden sensorineural hearing loss. Ir J Med Sci 190, 1165–1172 (2021). https://doi.org/10.1007/s11845-021-02610-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-021-02610-6

Keywords

Search

Navigation