Intratympanic treatment with dexamethasone as first-line or salvage therapy in sudden sensorineural hearing loss: Results of a retrospective study

Aim: Sudden sensorineural hearing loss is a condition of emergency in Otolaryngology. Although there is no universally accepted treatment protocol, corticosteroids, intravenous and oral, are the most common treatment The purpose of this study is to evaluate the efficacy of intratympanic administration of dexamethasone as first line therapy, or as a rescue therapy after treatment with systemic steroids in patients not responders. Methods: The population, consisting of 85 patients referred to our unit from January 2010 to December 2013, was divided into two groups according to the treatment protocol performed. We also analyzed possible variables that may affect the response to treatment such as age, smoking, and therapeutic delay. Results: Age and smoking did not exert any kind of influence on the response to treatment, unlike the therapeutic delay. In fact, patients treated within one week after the onset of the deafness, achieved an improvement of threshold for all frequencies tested. The group of patients treated with intratympanic injection as single therapy shows an improvement of the auditory threshold for all frequencies tested, but, in any event, is not statistically significant Conclusion: The exclusive use of desametasone by intratympanic has demonstrated effective. In addition, its use after the systemic steroid therapy changes the prognosis of patients improving their hearing threshold. Therefore, the infiltration of intratympanic corticosteroids is effective both as a first-line treatment and as salvage.