Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Combination of Pulse Steroid with Intratympanic Injections in Sudden Sensorineural Hearing Loss

Document Type : Original

Authors
Maryam Amizadeh 1
Karamat Mozafarinia 1
Javad Moslemikia 2
Ahmad Naghibzadeh-Tahami 3
1 Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
2 Clinical Research Unit, Jiroft University of Medical Science, Jiroft, Iran.
3 Modeling of Health Research Center, Institute for Futures Studies in Health, Kerman university of Medical Science, Kerman, Iran.
10.22038/ijorl.2020.43887.2452
Abstract
Introduction:
Oral prednisolone was suggested as the first step to treat idiopathic sudden sensorineural hearing loss (ISSHL). This study aimed to investigate the effect of pulse therapy with methylprednisolone and intratympanic methylprednisolone, compared to traditional oral prednisolone therapy on patients with ISSHL.
 
Materials and Methods:
This randomized control trial included an experimental group receiving 500 mg intravenous methylprednisolone for three sequential days, followed by 1 mg/kg oral prednisolone for 11 days, and intratympanic Depo-Medrol four times twice a week. On the other hand, the control group received 1 mg/kg oral prednisolone for 14 days. Hearing change was assessed through pure tone audiometry. Subsequently, hearing recovery was investigated and analyzed in this study.
 
Results:
This study was conducted on 51 patients who were divided into two groups of experimental (n=26) and control (n=25). The result revealed no significant difference between the two groups in terms of hearing improvement (P=0.28).
 
Conclusion:
This revealed no added benefit in pulse steroids combined with intratympanic injections in cases with sudden hearing loss.
Keywords
Intratympanic
Pulse therapy
Sudden sensorineural hearing loss
  1. Haberkamp TJ, Tanyer HM. Management of idiopathic sudden sensorineural hearing loss. AmOtol 2007; 20:587-595.
  2. Byl FM. sudden hearing loss: eight years’ experience and suggested prognostic table. Laryngoscope 2011; 94:647-661.
  3. Stokroos RJ, Albers FW, Tenverget EM. Antiviral treatment of idiopathic sudden sensorineural hearing loss. Acta otolaryngal 1998; 118:488-495.
  4. Stachler RJ, Chandrasekhar SS. Clinical practice guideline: sudden hearing loss. Amrican Academy of otolaryngology –head and neck surgery; 2012 Mar; 146: S1-35.
  5. Dermian H. Contribution of interatympanic steroids in the primary treatment of sudden hearing loss. ACATA OTO-LARYNGOLOGICA 2018: 1651-2251.
  6. Rauch SD, Halpin CF, Antonelli PJ, Babu S, Carey JP, Gantz BJ, et al. Oral vs interatympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: randomized trial. JAMA 2011; 305:20 71-2079.
  7. Sinha A, Begga A. Pulse steroid therapy. Indian J Pediatr 2008; 75:1057-1066
  8. Woods JE, Anderson CF, Doweerd JH. High dosage intravenously administered methylprednisolone in renal transplantation. A preliminary report. Jama1973; 223:896-899
  9. Panat SR, Aggarwal A, Joshi A. Pulse therapy: A boon or bane. J Dent Sci Oral Rehabil 2012; 3:1-3.  
  10. Gupta G, Jain A, Narayanasetty NK. Steroid pulse therapies in dermatology. Muller J Med Sci Res 2014; 5:155-8.
  11. Awad Z, Hunis C, Pothier DD. Antiviral for idiopathic sudden sensorineural hearing loss. Cochrance Database syst rev 2002; 15: CD 006987.
  12. Garavello W, Gallzzi F, Gaini RM, Zanetti D. Interatympanic panic steroid treatment for sudden deafness: a meta-analysis of randomized controlled trails. Otol neurotol 2010; 33:724-729.
  13. Crane RA, Camilon M, Nguyen S, Meyer TA. Steroid for treatment of sudden sensorineural hearing loss: a meta-analysis of randomized controlled trails. Laryngoscope 2017; 125:209-217.
  14. Li H, Feng G, Wang H, Feng Y. Intratympanic steroid therapy as a salvage treatment for sudden sensorineural hearing loss after failure of conventional therapy: a meta-analysis of randomized controlled trails. Clin ther 2011; 37:178-187.
  15. Kopke RD, Hoffer ME, Wester MD, Jakson RL. Targeted topical steroid therapy in sudden sensorineural hearing loss. Otol neural 2001; 22:
    475-479
  16. Stahn C, Lowenberg M, Hommes, DW, Buttgereiy F. Molecular mechanism of glucocorticoid receptor agonists. Mol cell Endocinal 2007; 275:
    71-78.
  17. Ryan AF, Pak K, Low W. Immunological damage to the inner ear: current and future therapeutic strategies. Adv Otorhinolaryngol 2012 59:66-74.
  18. Naronzny W, Sicko Z, Kot J, Kucszkoski J. Usefulness of high doses of glucocorticoids and hyperbaric oxygen therapy sudden sensorineural hearing loss treatment. Otol neurotol 2004; 25:916-923.
  19. Westerlaken BO, DE kleine E, Van der laan B, Albers F.  The treatment of idiopathic sudden sensorineural hearing loss using pulse therapy. Laryngoscope 2007; 117:684-690.
  20. Eftekharian A, Amizadeh M. Pulse steroid therapy in idiopathic sudden sensorineural Hearing loss: A randomized controlled clinical trial. laryngoscope 2015; 126:150-155.
  21. Jong Bin Lee, Seong Jun Choi. Potential Benefits of Combination Therapy as Primary Treatment for Sudden Sensorineural Hearing Loss. Otolaryngology-Head and Neck Surgery 2015;1-7.
  22. Arastou S, Tajeddini A, Borghei Combined intratympanic and systemic steroid therapy for poo- prognosis sudden sensorineural hearing loss. Iran J Otorhinolaryngeal.2013;25:23-28.
  23. Da Jung Jung, Ji Hye Park. The Efficacy of Combination Therapy for Idiopathic Sudden Sensorineural Hearing Loss. Laryngoscope; 2016 Dol:10.1002.
  24. Bae SC, Noh HL, Jun BC. Efficacy of intratympanic steroid therapy for idiopathic sudden sensorineural hearing loss: comparison with systemic steroid therapy and combined therapy. Acta Otolaryngol.2013;133:428-433.
  25. Arslan N, Oguz H, Demirei M. Combination intratympanic and systemic use of steroid for idiopathic sudden sensorineural hearing loss. Otol Neurotic 2011; 32:393-7.
  26. Battaglia A, Burchett R, Cueva R. Combination therapy 9 intratympanic dexamethasone+high-dose prednisolone taper) for the treatment of idiopathic sudden sensorineural hearing loss. Otol Neurotol2008; 29:435-6.

 

 

 

Iranian Journal of Otorhinolaryngology
Volume 33, Issue 1
January and February 2021
Pages 9-13