Intratympanic dexamethasone/hyaluronic acid mix as an adjunct to intravenous steroid and vasoactive treatment in patients with severe idiopathic sudden sensorineural hearing loss.

ABSTRACT

OBJECTIVE: To evaluate differences in effectiveness (hearing recovery rates) between idiopathic sudden sensorineural hearing loss (ISSNHL) patients treated with intravenous therapy alone and patients treated with a combination of intravenous and intratympanic therapy. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral hospital center. PATIENTS AND INTERVENTIONS: Ninety-four patients with moderate ISSNHL treated with an intravenous steroid and vasoactive regimen (duration of therapy, 9 ± 2.76 d) and 76 patients with severe ISSNHL treated with a combination regimen of intravenous and intratympanic therapy (duration of therapy, 10 ± 2.71 d) were reviewed. In the latter patients' group, a series of 3 intratympanic injections of a dexamethasone/hyaluronic acid mix solution were applied every 2 days. MAIN OUTCOME MEASURE: Pure-tone audiometric thresholds at 0.5, 1, 2, 4, and 8 kHz were compared between groups using the Wilcoxon test. RESULTS: Combination therapy in severe ISSNHL did not show any statistically significant difference in effectiveness to intravenous therapy in moderate ISSNHL (p > 0.05). CONCLUSION: In patients with severe ISSNHL, starting intratympanic steroid therapy as an adjunct early in the course of intravenous steroid and vasoactive therapy improves hearing to a level which is obtained in patients with less severe (moderate) ISSNHL treated with intravenous therapy alone.