S S Chandrasekhar1. 1. Division of Otolaryngology-HNS, UMDNJ-New Jersey Medical School and University Hospital, Newark, USA.
Abstract
OBJECTIVE: To discuss the value of intratympanic dexamethasone (IT-DEX) perfusion for sudden sensorineural hearing loss (SSNHL), clinically and in an animal model. STUDY DESIGN: Retrospective case review of 10 patients with SSNHL treated with IT-DEX. The findings are correlated with this institution's previous findings from a study of IT-DEX in guinea pigs. SETTING: Ambulatory tertiary otologic referral center. PATIENTS: Sequential patients with SSNHL who chose IT-DEX treatment. INTERVENTIONS: Dexamethasone 0.5 mg was injected transtympanically and bathed the round window for 20 minutes. Animal study: 79 ears were randomized into five groups: control, IT-DEX versus intravenous (IV)-DEX, IT-DEX with histamine, IT-DEX with hyaluronic acid, and IT-DEX with dimethylsulfoxide. MAIN OUTCOME MEASURES: Clinical study: postprocedure audiometry. Animal study: perilymph steroid concentration. RESULTS: IT-DEX results in significant hearing improvement and in significantly higher perilymph concentration of steroid than IV-DEX. CONCLUSIONS: IT-DEX is an appropriate treatment option for the treatment of SSNHL. Further study of dosages and frequency of administration is warranted.
OBJECTIVE: To discuss the value of intratympanic dexamethasone (IT-DEX) perfusion for sudden sensorineural hearing loss (SSNHL), clinically and in an animal model. STUDY DESIGN: Retrospective case review of 10 patients with SSNHL treated with IT-DEX. The findings are correlated with this institution's previous findings from a study of IT-DEX in guinea pigs. SETTING: Ambulatory tertiary otologic referral center. PATIENTS: Sequential patients with SSNHL who chose IT-DEX treatment. INTERVENTIONS:Dexamethasone 0.5 mg was injected transtympanically and bathed the round window for 20 minutes. Animal study: 79 ears were randomized into five groups: control, IT-DEX versus intravenous (IV)-DEX, IT-DEX with histamine, IT-DEX with hyaluronic acid, and IT-DEX with dimethylsulfoxide. MAIN OUTCOME MEASURES: Clinical study: postprocedure audiometry. Animal study: perilymph steroid concentration. RESULTS:IT-DEX results in significant hearing improvement and in significantly higher perilymph concentration of steroid than IV-DEX. CONCLUSIONS:IT-DEX is an appropriate treatment option for the treatment of SSNHL. Further study of dosages and frequency of administration is warranted.
Authors: I Dallan; L Bruschini; A Nacci; B Fattorp; A C Traino; F Rognini; G Ferraro; P Bruschini Journal: Acta Otorhinolaryngol Ital Date: 2006-02 Impact factor: 2.124