The Effect of Intratympanic Dexamethasone with Oral Prednisolone as a Primary Treatment in Idiopathic Sudden Sensorineural Hearing Loss

Introduction: Sudden sensorineural hearing loss (SSNHL) is a true emergency that must be diagnosed and treated immediately. The purpose of this study is to compare the efficacy of treatment with intratympanic dexamethasone plus oral prednisolone daily or every other day with that of treatment with oral prednisolone alone. Materials and Methods: Sixty-three patients with SSNHL that had been present for less than ۱۰ days prior to the start of treatment were randomly allocated to three different groups. Patients in group A were treated daily with oral prednisolone ۱ mg/kg for ۱۰ days plus intratympanic dexamethasone ۲ mg for the first ۳ days of treatment. Patients in group B were treated every other day with oral prednisolone ۱ mg/kg for ۱۰ days with the addition of intratympanic dexamethasone ۲ mg for the first ۳ treatments. Patients in group C were treated daily with oral prednisolone ۱ mg/kg alone for ۱۰ days. Audiometric parameters including pure tone audiometry (PTA), speech reception threshold (SRT), and speech discrimination score (SDS) were assessed on days ۱,۵, and ۱۰. Results: There was a significant improvement in PTA, SRT and SDS in each group over the ۱۰ days but the greatest improvement was seen in the SRT measurements of group A in comparison with group B (۱۹.۸۱ ± ۲.۱۵, P=۰.۰۴) and C (۲۶.۲۶ ± ۰.۰۸, P=۰.۰۱). The difference in SRT between groups B and C was not statistically significant. Conclusion: The administration of intratympanic dexamethasone ۲ mg daily for ۳ days has an additive effect to that of ۱۰ days of oral prednisolone ۱ mg/kg in the treatment of SSNHL.

Keywords:

Dexamethasone , Emergency , Oral , Otolaryngologic , Prednisolone , Pure tone audiometry , Sensorineural hearing loss , Speech discrimination test , Speech reception threshold test