OBJECTIVE: To investigate the effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss. METHOD: Forty-seven subjects received an atleast 7-day dexamethasone(5 g/L/d) or methylprednisolone (40 g/L/d) course. Pure-tone averages (PTA) of pre-injection and post-injection at 4-frequency (500, 1,000, 2,000, 4,000 Hz) were compared. More than 10 dB HL of improvement in PTA was considered to be clinically significant. RESULT: PTA of pre-injection and post-injection were (71.59 +/- 27.66) dB HL and (53.44 +/- 30.10) dB HL respectively in 24 patients with intratympanic dexamethasone. There was significant improvement in PTA (P<0.01), 1.67% of patients showed improvement in hearing. PTA of preinjection and post-injection were (68.64 +/- 25.21) dB HL and (55.76 +/- 26.42) dB HL respectively in 23 patients with intratympanicmethylprednisolone. There was significant improvement in PTA (P<0.01), 43% of patients showed improvement in hearing. There was no significant difference in PTA between intratympanic dexamethasone and methylprednisolone. After dexamethasone injection, evident improvement was accomplished in 11 cases who underwent treatment with other therapy (systemic steroids, vasodilator agent, or high-pressure-oxygen therapy) (P<0.05); PTA showed significant improvement in 13 cases with only intratympanic dexamethasone(P< 0.05). After methylprednisolone injection, evident improvement was accomplished in 17 cases who underwent treatment with other therapy (P<0.01); PTA decreased but had no significance in 6 cases with only intratympanic methyl-prednisolone(P>0.05). No unexpected adverse events such as otitis media, perforated tympanic membrane and worsening in hearing occurred during the injection or follow-up period. CONCLUSION:Intratympanic dexamethasone or methylprednisolone can be beneficial in treatment on patient with sudden sensorineural hearing loss, however, there was no significant difference in the effect between dexamethasone and methylprednisolone. Dexamethasone is recommended to use as favorable drug for intratympanic application that could be primary therapy in treatment on sudden sensorineural hearing loss.
RCT Entities:
OBJECTIVE: To investigate the effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss. METHOD: Forty-seven subjects received an at least 7-day dexamethasone(5 g/L/d) or methylprednisolone (40 g/L/d) course. Pure-tone averages (PTA) of pre-injection and post-injection at 4-frequency (500, 1,000, 2,000, 4,000 Hz) were compared. More than 10 dB HL of improvement in PTA was considered to be clinically significant. RESULT: PTA of pre-injection and post-injection were (71.59 +/- 27.66) dB HL and (53.44 +/- 30.10) dB HL respectively in 24 patients with intratympanic dexamethasone. There was significant improvement in PTA (P<0.01), 1.67% of patients showed improvement in hearing. PTA of preinjection and post-injection were (68.64 +/- 25.21) dB HL and (55.76 +/- 26.42) dB HL respectively in 23 patients with intratympanic methylprednisolone. There was significant improvement in PTA (P<0.01), 43% of patients showed improvement in hearing. There was no significant difference in PTA between intratympanic dexamethasone and methylprednisolone. After dexamethasone injection, evident improvement was accomplished in 11 cases who underwent treatment with other therapy (systemic steroids, vasodilator agent, or high-pressure-oxygen therapy) (P<0.05); PTA showed significant improvement in 13 cases with only intratympanic dexamethasone(P< 0.05). After methylprednisolone injection, evident improvement was accomplished in 17 cases who underwent treatment with other therapy (P<0.01); PTA decreased but had no significance in 6 cases with only intratympanic methyl-prednisolone(P>0.05). No unexpected adverse events such as otitis media, perforated tympanic membrane and worsening in hearing occurred during the injection or follow-up period. CONCLUSION: Intratympanic dexamethasone or methylprednisolone can be beneficial in treatment on patient with sudden sensorineural hearing loss, however, there was no significant difference in the effect between dexamethasone and methylprednisolone. Dexamethasone is recommended to use as favorable drug for intratympanic application that could be primary therapy in treatment on sudden sensorineural hearing loss.