Intratympanic Triamcinolone Acetonide as a Salvage Treatment for Idiopathic Sudden Sensorineural Hearing Loss

2021 ◽  
pp. 1-10
Author(s):  
Alexandros Andrianakis ◽  
Ulrich Moser ◽  
Axel Wolf ◽  
Peter Kiss ◽  
Clemens Holzmeister ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Triamcinolone Acetonide ◽  
Systemic Treatment ◽  
Salvage Treatment ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Partial Recovery ◽  
Hearing Improvement ◽  
Hearing Recovery

<b><i>Introduction:</i></b> Intratympanic steroid (ITS) injections represent an increasingly used salvage treatment option for patients with idiopathic sudden sensorineural hearing loss ­(ISSHL) after systemic treatment. The most effective corticosteroid for this treatment modality still remains unclear. Triamcinolone acetonide has been used for ITS treatment in various clinical settings. However, there are limited clinical data of its usage in the therapeutic management of ISSHL. The aim of this study was to determine the efficacy of intratympanic triamcinolone acetonide injections as a salvage treatment for ISSHL. <b><i>Methods:</i></b> We conducted a retrospective chart review on patients affected by ISSHL with insufficient hearing recovery after primary systemic corticosteroid therapy and who were treated with intratympanic triamcinolone acetonide as a salvage therapy between January 2014 and August 2019. The patients were divided into groups according to their degree of hearing recovery, and we evaluated potential predictors of hearing recovery. Audiometric results were then compared to historic studies using dexamethasone or methylprednisolone. <b><i>Results:</i></b> One-hundred and fifty-two patients received up to 3 intratympanic injections with triamcinolone acetonide at 1-week intervals. The mean hearing improvement due to ITS salvage treatment was 15.9 ± 18.9 dB. Complete hearing recovery was noted in 15 patients (9.9%), while 73 patients (48%) obtained partial recovery, and 64 patients (42.1%) had no recovery. Primary systemic treatment delay, hearing improvement by primary systemic treatment, and severity of initial hearing loss were identified as significant predictors of hearing improvement. The first of the 3 injections resulted in the greatest hearing improvement. <b><i>Conclusion:</i></b> The use of triamcinolone acetonide in ITS salvage treatment resulted in similar hearing improvements as the use of the commonly used corticosteroids, namely, dexamethasone and methylprednisolone. Longer treatment delays, lower hearing improvement by primary systemic treatment, and higher initial hearing loss are associated with poorer prognoses of hearing recovery.

Intratympanic dexamethasone for profound idiopathic sudden sensorineural hearing loss

2005 ◽  
Vol 132 (6) ◽  
pp. 902-905 ◽  
Author(s):  
Robert A. Battista
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Treatment Protocol ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Additional Patient ◽  
Prospective Clinical Study ◽  
Partial Recovery ◽  
Hearing Recovery ◽  
Intratympanic Dexamethasone

OBJECTIVES: To determine hearing recovery by using intratympanic dexamethasone for profound, idiopathic sudden sensorineural hearing loss (ISSNHL). STUDY DESIGN AND SETTING: A prospective, clinical study was performed of 25 consecutive patients seen with profound ISSNHL. Patients received 4 intratympanic treatments of dexamethasone over the course of 2 weeks. Complete hearing recovery was defined as the final pure-tone average (PTA) within 10 dB of baseline. Partial recovery was defined as a final PTA with >50% hearing. The hearing in the contralateral ear was used as baseline. RESULTS: The average time to treatment was 28 days. Two patients had significant hearing recovery, and 1 additional patient had partial recovery. The 2 patients with significant hearing recovery were treated within 9 days of onset of hearing loss. CONCLUSIONS: By using the treatment protocol and definition of hearing recovery of this study, intratympanic dexamethasone does not result in significant hearing improvement for patients with profound ISSNHL. There is a possible trend for improved hearing results if intratympanic treatment is performed within 11 days of onset of hearing loss.

scholarly journals Treatment of sudden sensorineural hearing loss with hyperbaric oxygenation - our experience

2017 ◽  
Vol 74 (2) ◽  
pp. 156-160 ◽  
Author(s):  
Zvonko Zivaljevic ◽  
Ljubica Zivic ◽  
Natasa Mihailovic ◽  
Miodrag Zivkovic ◽  
Branko Vorkapic ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hyperbaric Oxygenation ◽  
Medical Center ◽  
Hearing Threshold ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Partial Recovery ◽  
Treatment Protocols ◽  
Hearing Recovery

Background/Aim. Sudden sensorineural hearing loss is manifested by the loss of hearing for more than 30 dB at three consecutive frequencies in the timeframe of 72 h. It is of unclear etiology and pathogenesis, which leads to the use of different therapeutic methods. Treatment protocols are not compliant, making it difficult to objectively quantify their impact. The aim of this study was to show the effect of hyperbaric oxygen therapy as the only method for the treatment of sudden sensorineural hearing loss. Methods. This retrospective study included 20 patients treated for sudden sensorineural hearing loss with hyperbaric oxygenation (HBO) in the period from 2004 to 2014. The study was conducted in the specialized medical clinic for hyperbaric and underwater medicine, HBO Medical Center in Belgrade. The patients were treated according to the following protocol: a session of 60 min at the pressure of 2 bars (2ATA) two times a day, a total of 30 sessions. Assessment of the therapy effects was performed by observing the change in the hearing threshold at the frequencies of 500, 1,000, 2,000 and 4,000 Hz at the end of the treatment. Results. After the completion of treatment according to the protocol, a full hearing recovery (total improvement of hearing damage or achieving final hearing threshold above 25 dB) was found in 11 (55%) of the patients. A partial recovery (hearing improvement of up to 15 dB, and a final hearing threshold below 45 dB) occurred in 4 (20%) of the patients. In 5 (25%) of the patients, improvement was not verified (there was no recovery or it was less than 5 dB). The average absolute hearing recovery was 24.94 dB. The mean relative hearing recovery was 65.45%. Conclusion. Because of the unclear multifactorial etiopathogenesis of this disease, there are many therapeutic protocols. Based on the results of our study HBO therapy could be recommended primarily as the treatment for sudden sensorineural hearing loss.

scholarly journals Effectiveness of Various Treatments for Sudden Sensorineural Hearing Loss—A Retrospective Study

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 96
Author(s):  
Magdalena B. Skarżyńska ◽  
Aleksandra Kołodziejak ◽  
Elżbieta Gos ◽  
Milaine Dominici Sanfis ◽  
Piotr H. Skarżyński
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Success Rate ◽  
Complete Recovery ◽  
Sudden Onset ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Prolonged Treatment ◽  
Retrospective Clinical Study ◽  
Hearing Recovery

(1) Background: A retrospective clinical study was conducted to compare the effectiveness of different pharmacological and non-pharmacological regimens for treating sudden sensorineural hearing loss (SSNHL). (2) Methods: Adult patients (n = 130) diagnosed with sudden sensorineural hearing loss (SSNHL) and hospitalized between 2015 and 2020 were enrolled in this study. Depending on the treatment regimen applied, patients were divided into five groups. Inclusion criteria were as follows: (i) hearing loss of sudden onset; (ii) hearing loss of at least 30 dB at three consecutive frequencies; (iii) unilateral hearing loss; (iv) age above 18 years. Exclusion criteria were as follows: (i) no follow-up audiogram; (ii) bilateral hearing loss; (iii) recognized alternative diagnosis such as tumor, disorder of inner ear fluids, infection or inflammation, autoimmune disease, malformation, hematological disease, dialysis-dependent renal failure, postdural puncture syndrome, gene-related syndrome, mitochondrial disease; and (iv) age below 18 years. (3) Results: Complete recovery was found in 14% of patients (18/130) and marked improvement was found in 6% (8/130), giving an overall success rate of 20%. The best results were obtained in the second group (i.e., patients given intratympanic glucocorticoid + prolonged orally administered glucocorticoid) where the success rate was 28%. In general, the older the patient, the smaller the improvement in hearing, a correlation that was statistically significant. (4) Conclusions: In treating SSNHL, the highest rate of hearing recovery—28%—was in the group of patients given intratympanic corticoid plus prolonged treatment with orally administered glucocorticoid.

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