The Effect of Intratympanic Injection of Dexamethasone for the Treatment of Sudden Sensorineural Hearing Loss

Abstract
Background: Steroids remain the treatment of choice for sudden hearing loss regardless the cause. With the adverse effects of systemic corticosteroids, Intratympanic injection of steroids appears to be an attractive method of management of Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) in patients with contraindication for systemic steroids.
Patients and Methods: 40 patients, presented with mod-erate to severe and severe SSNHL were enrolled in the study. Patients were randomly allocated in one of two groups: (Group I) received intratympanic injection of dexamethasone 4mg for 5 times over 4 weeks and (Group II) received systemic steroid 1mg/kg for one week and tapering the dose for two weeks. Pure Tone Audiogram (PTA) and Speech Discrimina-tion (SD) were used for assessment pre and post-treatment in the two groups.
Results: Group I treated with intratympanic injection of dexamethasone showed hearing improvement in 45% of patients (9 patients) and no improvement in 55% of patients (11 patients), while Group II treated with systemic corticos-teroids showed hearing improvement in 60% of patients (12 patients) and no improvement in 40% of patients (8 patients). The degree of improvement showed no statistically difference between both groups.
Conclusions: The intratympanic injection of dexametha-sone is an effective alternative to systemic steroids in treatment of ISSNHL as a primary therapy.