Background and Aims Intratympanic steroid (ITS) therapy is recommended as salvage treatment for idiopathic sudden sensorineural hearing loss (ISSHL) after failure of primary systemic treatment. The most effective corticosteroid for this treatment modality still remains elusive. Recent experimental studies suggested that triamcinolone acetonide has a favorable pharmacokinetic profile for local therapy of hearing disorders. Only few clinical data of TA as salvage treatment for ISSHL exists. The objective of this study was to determine the efficacy of intratympanic applied TA as salvage treatment of ISSHL.
Methods All ISSHL patients who received ITS salvage treatment with triamcinolone acetonide between January 2014 to August 2019 at the Department of Otorhinolaryngology, Medical University of Graz were retrospectively evaluated. Hearing improvement was calculated as absolute change in 4-frequency pure-tone average from salvage treatment start to one-week follow up. Grade of hearing recovery was determined according to well-established Wilson criteria.
Results In total, 152 patients obtained up to three intratympanic triamcinlone acetonide injections at one-week intervals. The absolute hearing improvement due to ITS salvage treatment was 15.9 ± 18.9 dB. Complete, partial and no hearing recovery were achieved from 15 (9.9 % ), 73 (48 % ) and 64 (42.1 % ) patients, respectively.
Conclusion Triamcinolone acetonide resulted in similar hearing improvement compared to those of historic cohorts using dexamethasone or methylprednisolone. Therefore, triamcinolone acetonide constitutes an effective drug alternative for ITS salvage treatment of ISSHL.
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