Methylprednisolone Intratympanic Injection in Idiopathic Sudden Sensorineural Hearing Loss: A Retrospective Review of 167 Cases

Siriporn Limviriyakul MD 1 , Kanthong Thongyai MD 1 , Sarun Prakairungthong MD 1 , Suvajana Atipas MD 1 , Samut Chongvisal MD 1

Affiliation : 1 Department of Otorhinolaryngology, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Objective : To investigate if methylprednisolone intratympanic membrane injection (IT) as a salvage treatment gave an additional hearing improvement in patients with idiopathic sudden sensorineural hearing loss [ISSNHL].
Material and Methods: A retrospective medical chart review of 167 patients diagnosed as ISSNHL with onset of hearing loss prior to methylprednisolone IT 30 days or less. Patients, who did not response to 1-week course of high dose oral steroid, were given 4 times of methylprednisolone IT within 1 week. Data were analyzed to compare hearing improvement.
Results : There were 167 patients with ISSHNL included in the present study, 63 (37.7%) males and 104 (62.3%) females. Age range was 14 - 87 years old (median 52, mean ± SD: 51.56 ± 14.51). Median onset of ISSNHL before starting methylprednisolone IT was 8 days (mean ± SD; 13.42 ± 12.62 days) and mean of initial PTA of pathological ears were 70.96 ± 26.54 dB. Methylprednisolone IT provided improvement in hearing 25.1% with statistical significance (p<0.001) after 30 days of treatment. The common side effects were pain and vertigo. Twelve patients (7.18%) had tympanic membrane perforation, but there was no serious adverse effect.
Conclusion : Methylprednisolone IT is an effective salvage treatment in ISSNHL and could be considered as a primary treatment for patients

Keywords : Sudden hearing loss, sudden sensorineural hearing loss, Intratympanic steroid, Intratympanic injection

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