Document Detail


Effectiveness of intratympanic dexamethasone injection in sudden-deafness patients as salvage treatment.
MedLine Citation:
PMID:  15235345     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the effectiveness of intratympanic dexamethasone (IT-DEX) in patients with severe or profound sudden sensorineural hearing loss (SSNHL) after treatment failure with conventional therapy. STUDY DESIGN: Randomized, controlled study. METHODS: Patients who met the criteria for SSNHL, with a severity of severe to profound, underwent 10 days of standard treatment with oral steroid and other facilitating agents. Patients showing poor response to standard treatment were assigned randomly to a control group or to a group receiving IT-DEX. IT-DEX injections were performed once a week for 3 consecutive weeks. Pure-tone audiometry was obtained before each injection. Minimum follow-up time was 1 month. Successful treatment was defined as a hearing improvement of greater than 30 dB. RESULTS: Thirty-nine patients meeting the inclusion criteria were studied. After treatment with oral steroid, 10 of 39 (26%) patients demonstrated hearing improvement, whereas the remaining 29 (74%) patients showed a hearing improvement of less than 30 dB. For those without hearing improvement, 15 received IT-DEX, and 14 received further standard treatment (except oral steroid and carbogen inhalation). Hearing improved in 8 of 15 (53.3%) compared with 1 of 14 (7.1%), with an average decrease in threshold of 28.4 dB and 13.2 dB for the IT-DEX group and the control group, respectively (P <.05). Prognostic factors such as age, treatment delay time, and sex did not significantly affect the response to therapy. CONCLUSIONS: IT-DEX injection effectively improves hearing in patients with severe or profound SSNHL after treatment failure with standard therapy and is not associated with major side effects. It is therefore a reasonable alternative as salvage treatment.
Authors:
Ho Guan-Min Ho; Hung-Ching Lin; Min-Tsan Shu; Cheng-Chien Yang; Hsun-Tien Tsai
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Laryngoscope     Volume:  114     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-05     Completed Date:  2004-08-26     Revised Date:  2005-03-07    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1184-9     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents / administration & dosage,  therapeutic use*
Audiometry, Pure-Tone
Chi-Square Distribution
Child
Dexamethasone / administration & dosage,  therapeutic use*
Hearing Loss, Sudden / drug therapy*
Humans
Injections
Middle Aged
Salvage Therapy
Treatment Outcome
Tympanic Membrane
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 50-02-2/Dexamethasone
Comments/Corrections
Comment In:
Laryngoscope. 2005 Feb;115(2):378; author reply 378-9   [PMID:  15689773 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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