Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-23T09:47:36.871Z Has data issue: false hasContentIssue false
  • English
  • Français

Intratympanic methylprednisolone perfusion as a salvage treatment for profound idiopathic sudden sensorineural hearing loss

Published online by Cambridge University Press:  14 March 2017

Y Dai ,
L Lu ,
J Hou ,
X Yang ,
H Li ,
Y Yang  and
W She
Y Dai
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, People's Republic of China Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, People's Republic of China
L Lu
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, People's Republic of China
J Hou
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, People's Republic of China
X Yang
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, People's Republic of China
H Li
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, People's Republic of China
Y Yang
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, People's Republic of China
W She*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, People's Republic of China Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, People's Republic of China
*
Address for correspondence: Prof. W She, Department of Otolaryngology – Head and Neck Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China Fax: +86 25 8331 7016 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study aimed to examine the effectiveness of intratympanic methylprednisolone perfusion as salvage treatment for profound idiopathic sudden sensorineural hearing loss.

Methods:

A retrospective clinical study of 97 patients with unilateral profound idiopathic sudden sensorineural hearing loss was performed. In all, 83 patients who received salvage intratympanic methylprednisolone perfusion plus conventional treatment (except for steroids) as the second-line therapy were assigned to the study group, while 14 patients who received conventional treatment alone were assigned to the comparison group.

Results:

In the study group, treatments in patients with a shorter interval from disease onset to intratympanic methylprednisolone perfusion (up to 15 days) had significantly greater improvements in the overall effective rate and pure tone average compared with patients with a longer interval (over 15 days). For patients with a short interval from disease onset to intratympanic methylprednisolone perfusion, those in the study group had significantly greater improvements in the overall effective rate and pure tone average compared with those in the comparison group. In both the study and comparison groups, hearing improvements were greater at low frequencies than at medium and high frequencies.

Conclusion:

The interval from disease onset to intratympanic methylprednisolone perfusion was the major factor affecting hearing recovery. Early second-line salvage intratympanic methylprednisolone perfusion significantly improved the degree of hearing recovery in profound idiopathic sudden sensorineural hearing loss patients after failure of systemic steroid treatment.

Keywords

Hearing LossPerfusion, MethylprednisoloneSalvage Therapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 5 , May 2017 , pp. 404 - 410
Copyright
Copyright © JLO (1984) Limited 2017 

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 Schreiber, BE, Agrup, C, Haskard, DO, Luxon, LM. Sudden sensorineural hearing loss. Lancet 2010;375:1203–11CrossRefGoogle ScholarPubMed
2 Wilson, WR, Byl, FM, Laird, N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol 1980;106:772–6CrossRefGoogle ScholarPubMed
3 Schuknecht, HF. Ablation therapy for the relief of Meniere's disease. Laryngoscope 1956;66:859–70CrossRefGoogle ScholarPubMed
4 Chandrasekhar, SS, Rubinstein, RY, Kwartler, JA, Gatz, M, Connelly, PE, Huang, E et al. Dexamethasone pharmacokinetics in the inner ear: comparison of route of administration and use of facilitating agents. Otolaryngol Head Neck Surg 2000;122:521–8Google ScholarPubMed
5 Parnes, LS, Sun, AH, Freeman, DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope 1999;109:1–17 CrossRefGoogle ScholarPubMed
6 Tsai, HT, Hsueh, N, Huang, CM, Lin, HC. Intratympanic steroid injection as a first-line therapy in uremia patients with sudden sensorineural hearing loss. Acta Otolaryngol 2015;135:786–90CrossRefGoogle ScholarPubMed
7 Filipo, R, Covelli, E, Balsamo, G, Attanasio, G. Intratympanic prednisolone therapy for sudden sensorineural hearing loss: a new protocol. Acta Otolaryngol 2010;130:1209–13CrossRefGoogle ScholarPubMed
8 Battaglia, A, Burchette, R, Cueva, R. Combination therapy (intratympanic dexamethasone + high-dose prednisone taper) for the treatment of idiopathic sudden sensorineural hearing loss. Otol Neurotol 2008;29:453–60CrossRefGoogle ScholarPubMed
9 Ahn, JH, Yoo, MH, Yoon, TH, Chung, JW. Can intratympanic dexamethasone added to systemic steroids improve hearing outcome in patients with sudden deafness? Laryngoscope 2008;118:279–82CrossRefGoogle ScholarPubMed
10 Ho, GM, Lin, HG, Shu, MT. Effectiveness of intratympanic dexamethasone injection in sudden deafness patients as salvage treatment. Laryngoscope 2004;114:1184–9Google ScholarPubMed
11 Belhassen, S, Saliba, I. Intratympanic steroid injection as a salvage treatment for sudden sensorineural hearing loss. J Laryngol Otol 2014;128:1044–9CrossRefGoogle ScholarPubMed
12 Plaza, G, Herraiz, C. Intratympanic steroids for treatment of sudden hearing loss after failure of intravenous therapy. Otolaryngol Head Neck Surg 2007;137:74–8CrossRefGoogle ScholarPubMed
13 Moon, IS, Lee, JD, Kim, J, Hong, SJ, Lee, WS. Intratympanic dexamethasone is an effective method as a salvage treatment in refractory sudden hearing loss. Otol Neurotol 2011;32:1432–6CrossRefGoogle ScholarPubMed
14 She, W, Dai, Y, Du, X, Yu, C, Chen, F, Wang, J et al. Hearing evaluation of intratympanic methylprednisolone perfusion for refractory sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2010;142:266–71CrossRefGoogle ScholarPubMed
15 Trune, DR, Kempton, JB. Aldosterone and prednisolone control of cochlear function in MRL/MpJ-Fas(lpr) autoimmune mice. Hear Res 2001;155:9–20 CrossRefGoogle ScholarPubMed
16 Mathers, C, Smith, A, Concha, M. Global burden of hearing loss in the year 2000. In: www.who.int/healthinfo/statistics/bod_hearingloss.pdf [24 December 2016]Google Scholar
17 Chinese Sudden Hearing Loss Multi-Center Clinical Study Group. Prospective clinical multi-center study on the treatment of sudden deafness with different typings in China [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013;48:355–61Google Scholar
18 Edizer, DT, Çelebi, Ö, Hamit, B, Baki, A, Yiğit, Ö. Recovery of idiopathic sudden sensorineural hearing loss. J Int Adv Otol 2015;11:122–6CrossRefGoogle ScholarPubMed
19 Hou, J, She, W, Du, X, Dai, Y, Xie, L, Zhou, Q. Histone deacetylase 2 in sudden sensorineural hearing loss patients in response to intratympanic methylprednisolone perfusion. Otolaryngol Head Neck Surg 2016;154:164–70CrossRefGoogle ScholarPubMed
20 Michel, O, Deutsche Gesellschaftfür Hals-Nasen-Ohren-Heilkunde, Kopf-und Hals-Chirurgie. The revised version of the German guidelines ‘sudden idiopathic sensorineural hearing loss’. Laryngorhinootologie 2011;90:290–93CrossRefGoogle ScholarPubMed
21 Stachler, RJ, Chandrasekhar, SS, Archer, SM, Rosenfeld, RM, Schwartz, SR, Barrs, DM et al. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012;146:S1–35CrossRefGoogle ScholarPubMed
22 Banerjee, A, Parnes, LS. Intratympanic corticosteroids for sudden idiopathic sensorineural hearing loss. Otol Neurotol 2005;26:878–81CrossRefGoogle ScholarPubMed
23 Ito, S, Fuse, T, Yokota, M, Watanabe, T, Inamura, K, Gon, S et al. Prognosis is predicted by early hearing improvement in patients with idiopathic sudden sensorineural hearing loss. Clin Otolaryngol Allied Sci 2002;27:501–4CrossRefGoogle ScholarPubMed
24 Plaza, G, Herráiz, C. Intratympanic steroids for treatment of sudden hearing loss after failure of intravenous therapy. Otolaryngol Head Neck Surg 2007;137:74–8CrossRefGoogle ScholarPubMed
25 Rauch, SD. Intratympanic steroids for sensorineural hearing loss. Otolaryngol Clin North Am 2004;37:1061–74CrossRefGoogle ScholarPubMed
26 Mattox, DE, Simmons, FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463–80CrossRefGoogle ScholarPubMed
27 Piccirillo, JF. Steroids for idiopathic sudden sensorineural hearing loss: some questions answered, others remain. JAMA 2011;305:2114–15CrossRefGoogle ScholarPubMed
28 Rauch, SD. Clinical practice. Idiopathic sudden sensorineural hearing loss. N Engl J Med 2008;359:833–40CrossRefGoogle ScholarPubMed
29 Shirwany, NA, Seidman, MD, Tang, W. Effect of transtympanic injection of steroids on cochlear blood flow, auditory sensitivity, and histology in the guinea pig. Am J Otol 1998;19:230–5Google ScholarPubMed
30 Fukushima, M, Kitahara, T, Uno, Y, Fuse, Y, Doi, K, Kubo, T. Effects of intratympanic injection of steroids on changes in rat inner ear aquaporin expression. Acta Otolaryngol 2002;122:600–6CrossRefGoogle ScholarPubMed
31 Plontke, SK, Biegner, T, Kammerer, B, Delabar, U, Salt, AN. Dexamethasone concentration gradients along scala tympani after application to the round window membrane. Otol Neurotol 2008;29:401–6CrossRefGoogle Scholar
32 Sha, SH, Taylor, R, Forge, A, Schacht, J. Differential vulnerability of basal and apical hair cells is based on intrinsic susceptibility to free radicals. Hear Res 2001;155:1–8 CrossRefGoogle ScholarPubMed
33 Billett, TE, Thorne, PR, Gavin, JB. The nature and progression of injury in the organ of Corti during ischemia. Hear Res 1989;41:189–97CrossRefGoogle ScholarPubMed
34 Alzamil, KS, Linthicum, FH Jr. Extraneous round window membranes and plugs: possible effect on intratympanic therapy. Ann Otol Rhinol Laryngol 2000;109:30–2CrossRefGoogle ScholarPubMed