Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T18:57:12.806Z Has data issue: false hasContentIssue false

Effect of intratympanic steroid administration on sensorineural hearing loss associated with acute otitis media

Published online by Cambridge University Press:  18 April 2016

R L Heywood*
Affiliation:
Department of Otolaryngology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
S N Ifeacho
Affiliation:
Department of Otolaryngology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
A A Narula
Affiliation:
Department of Otolaryngology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
*
Address for correspondence: Ms Rebecca L Heywood, Department of Otolaryngology, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, UK E-mail: [email protected]

Abstract

Objective:

To evaluate a small cohort of patients who presented with symptoms and signs consistent with acute infective sensorineural hearing loss who were treated with intratympanic steroids.

Method:

Seven patients received a 7-day course of oral antibiotics and oral prednisolone followed by 3 intratympanic injections of methylprednisolone and 1 week of topical dexamethasone drops.

Results:

Hearing improved in 57 per cent of patients (four out of seven). The mean improvement in this group was 24 dB (range, 10–52 dB). The magnitude of the sensorineural hearing loss at presentation was less in those who responded to intratympanic steroid therapy than in non-responders (mean pure tone average of 30 dB versus 65 dB pre-intratympanic steroids, and 14 dB versus 83 dB post-intratympanic steroids, respectively).

Conclusion:

The results of our study suggest that intratympanic steroids provide a valuable contribution to the treatment of acute infective sensorineural hearing loss and may provide additional benefit by virtue of a concentrated local steroid effect in patients who do not respond to antibiotics.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Park, JH, Park, SJ, Kim, YH, Park, MH. Sensorineural hearing loss: a complication of acute otitis media in adults. Eur Arch Otorhinolaryngol 2014;271:1879–84CrossRefGoogle ScholarPubMed
2 Roland, PS, Kreisler, LS, Reese, B, Anon, JB, Lanier, B, Conroy, PJ et al. Topical ciprofloxacin/dexamethasone otic suspension is superior to ofloxacin otic solution in the treatment of children with acute otitis media with otorrhea through tympanostomy tubes. Pediatrics 2004;113:e40–6Google Scholar
3 Chonmaitree, T, Saeed, K, Uchida, T, Heikkinen, T, Baldwin, CD, Freeman, DH Jr et al. A randomized, placebo-controlled trial of the effect of antihistamine or corticosteroid treatment in acute otitis media. J Pediatr 2003;143:377–85Google Scholar
4 MacArthur, CJ, DeGagne, JM, Kempton, JB, Trune, DR. Steroid control of acute middle ear inflammation in a mouse model. Arch Otolaryngol Head Neck Surg 2009;135:453–7Google Scholar
5 Joglekar, S, Morita, N, Cureoglu, S, Schachern, PA, Deroee, AF, Tsuprun, V et al. Cochlear pathology in human temporal bones with otitis media. Acta Otolaryngol 2010;130:472–6Google Scholar
6 Seggas, I, Koltsidopoulos, P, Bibas, A, Tzonou, A, Sismanis, A. Intratympanic steroid therapy for sudden hearing loss: a review of the literature. Otol Neurotol 2010;32:2935 CrossRefGoogle Scholar
7 Engel, F, Blatz, R, Kellner, J, Palmer, M, Weiler, U, Bhakdi, S. Breakdown of the round window membrane permeability barrier evoked by streptolysin O: possible etiologic role in development of sensorineural hearing loss in acute otitis media. Infect Immun 1995;63:1305–10CrossRefGoogle ScholarPubMed
8 Engel, F, Blatz, R, Schliebs, R, Palmer, M, Bhakdi, S. Bacterial cytolysin perturbs round window membrane permeability barrier in vivo: possible cause of sensorineural hearing loss in acute otitis media. Infect Immun 1998;66:343–6Google Scholar
9 Jang, CH, Cho, YB, Choi, CH, Park, SY, Pak, SC. Effect of topical dexamethasone on sensorineural hearing loss in endotoxin-induced otitis media. In Vivo 2007;21:1043–7Google Scholar
10 Fearrington, SJ, Weider, DJ. Sensori-neural hearing loss in acute otitis media due to beta-hemolytic streptococcus successfully treated with penicillin and prednisone. Ear Nose Throat J 1991;70:513–19Google ScholarPubMed
11 Song, JE, Sapthavee, A, Cager, GR, Saadia-Redleaf, MI. Pseudo-sudden deafness. Ann Otol Rhinol Laryngol 2012;121:96–9CrossRefGoogle ScholarPubMed