Objective: To discuss the value of intratympanic dexamethasone (IT-DEX) per
fusion for sudden sensorineural hearing loss (SSNHL), clinically and in an
animal model.
Study Design: Retrospective case review of 10 patients with SSNHL treated w
ith IT-DEX. The findings are correlated with this institution's previous fi
ndings from a study of IT-DEX in guinea pigs.
Setting: Ambulatory tertiary otologic referral center.
Patients: Sequential patients with SSNHL who chose IT-DEX treatment.
Interventions: Dexamethasone 0.5 mg was injected transtympanically and bath
ed the round window for 20 minutes. Animal study: 79 ears were randomized i
nto five groups: control, IT-DEX versus intravenous (IV)-DEX, IT-DEX with h
istamine, IT-DEX with hyaluronic acid, and IT-DEX with dimethylsulfoxide.
Main Outcome Measures: Clinical study: postprocedure audiometry. Animal stu
dy: perilymph steroid concentration.
Results: IT-DEX results in significant hearing improvement and in significa
ntly higher perilymph concentration of steroid than IV-DEX.
Conclusions: IT-DEX is an appropriate treatment option for the treatment of
SSNHL. Further study of dosages and frequency of administration is warrant
ed.