Systemic steroids and intratympanic steroids perfusion as an initial therapy for idiopathic sudden sensorineural hearing loss; a comparative study.

Citation:
Hazem Aboul Oyoun, M. D., M. D. Maha Abou-Elew, M. D. Mohamed Mosleh, M. D. HESHAM FATHY, M. D. WAEL WAGEEH, and M. A. Hassan, Systemic steroids and intratympanic steroids perfusion as an initial therapy for idiopathic sudden sensorineural hearing loss; a comparative study., , 2013.

Abstract:

Objective: The objective of this study is to compare the efficacy of systemic steroids (SS) and the intratympanic steroids (ITS) in the treatment of idiopathic sudden sensorineural hearing loss (SSNHL). Study design: This is a prospective study. Material and methods: This study included 21 patients suffering from idiopathic SSNHL. They were divided into 2 groups according to the modality of treatment. Group A included 10 patients who were treated with SS and group B included 11 patients who were treated with ITS due to their refusal or contraindication to take SS. A pre-treatment pure tone audiometry (PTA) was performed for all patients at their first presentation for establishment of the
diagnosis and assessment of the degree of the hearing loss. A post-treatment PTA was done at the follow up visit 2 weeks later for the assessment of the degree of hearing loss and hearing improvement. The data of both groups were compared together. Results: For group A the pre-treatment PTA average ranged from 37.5 to 113.3 db with a mean of 72.3± 25.11 db and the post-treatment PTA average ranged from 13.3 to 113.3 db with a mean of 49.24± 33.72 db. On comparing the means of the pre-treatment and the post-treatment PTA averages the difference was found to be statistically significant (P=0.03). The overall hearing improvement rate using SS was 60%. For group B the pre-treatment PTA average ranged from 50 to 115 db with a mean of 77± 18.98 db and the post-treatment PTA average ranged from 26.6 to 101.8 db with a mean of 50.05± 23.3 db. On comparing the means of the pre-treatment and the post-treatment PTA averages the difference was found to be statistically highly significant (P=0.001). The overall hearing improvement rate using ITS was 72.7%. Conclusion: Both SS and ITS have proven to be effective in the treatment of idiopathic SSNHL, however SS seems to have a better effect in terms of cure with complete recovery to normal hearing, while ITS exerts most of its effect in partial recovery.