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CC BY-NC-ND 4.0 · International Journal of Practical Otolaryngology 2023; 06(01): e24-e30
DOI: 10.1055/s-0043-1770369
Original Article

Comparison of Intratympanic and Systemic Steroid Therapy as Primary Treatments for Idiopathic Sudden Sensorial Hearing Loss

Sayaka Fuji
1   Department of Otolaryngology, Japanese Red Cross Okayama Hospital, Okayama, Japan
,
Ayako Takeuchi
1   Department of Otolaryngology, Japanese Red Cross Okayama Hospital, Okayama, Japan
,
Akifumi Kariya
2   Department of Otolaryngology, Japanese Red Cross Society, Himeji Hospital, Himeji, Hyogo, Japan
,
Naoki Akisada
3   Department of Otolaryngology—Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
,
Takahisa Koyama
1   Department of Otolaryngology, Japanese Red Cross Okayama Hospital, Okayama, Japan
,
Iku Fujisawa
3   Department of Otolaryngology—Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
,
Koji Hamada
1   Department of Otolaryngology, Japanese Red Cross Okayama Hospital, Okayama, Japan
,
Hisashi Ishihara
1   Department of Otolaryngology, Japanese Red Cross Okayama Hospital, Okayama, Japan
4   Kobayashi Ear, Nose & Throat Clinic, Kurashiki, Okayama, Japan
,
Seiko Akagi
1   Department of Otolaryngology, Japanese Red Cross Okayama Hospital, Okayama, Japan
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Abstract

Recently, intratympanic steroid (ITS) therapy has been used as a primary or salvage treatment for idiopathic sudden sensorineural hearing loss (ISSHL). In the present study, we retrospectively compared the efficacies of ITS and systemic steroid (SS) therapies as primary treatments for ISSHL. This study included 112 patients treated for ISSHL at our hospital, of which 44 received ITS therapy and 68 received SS therapy. Regarding patient background characteristics, the mean age (76 vs. 65 years, p < 0.0001) and percentage of patients with diabetes mellitus (55 vs. 18%, p < 0.0001) were significantly higher in the ITS group than in the SS group, whereas the rate of prior steroid use was lower in the ITS group than in the SS group (9 vs. 31%, p = 0.0068). After 3 weeks, the treatment response was cure, marked recovery, recovery, and no change in 11, 9, 8, and 16 patients in the ITS group and 32, 11, 5, and 20 patients in the SS group, respectively. Accordingly, the SS group was found to have a significantly higher cure rate than the ITS group (47 vs. 25%, p = 0.0191), with similar findings after propensity score matching (48 vs. 22%, p = 0.0461). Therefore, SS therapy is recommended as a primary treatment for ISSHL in patients who are not old or at a high risk of SS therapy-associated complications.

Keywords

idiopathic sudden sensorineural hearing loss - intratympanic steroid therapy - primary treatment


Publication History

Received: 17 October 2022

Accepted: 10 February 2023

Article published online:
16 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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