Transtympanic steroids for treatment of sudden hearing loss

OBJECTIVES: To determine whether transtympanic steroid administration may b e an effective treatment for sudden onset sensorineural hearing loss (SSNHL ) in patients for whom systemic steroid treatment has failed or who were no t candidates for systemic steroids. METHODS: The standard medical regimen for SSNHL usually involves systemic s teroid therapy. Unfortunately, some patients do not respond successfully to or are poorly tolerant of systemic steroids. Transtympanic administration of steroids has been suggested as an alternative to systemic therapy. A pro spective study was designed to evaluate the hearing outcomes in SSNHL patie nts treated with transtympanic steroids. Patients received transtympanic st eroids if oral steroids had failed to work or if they were not able to tole rate oral steroids. Transtympanic steroids were administered through a vent ilation tube placed with the patient under local anesthesia. Steroid admini stration was performed on 4 separate occasions over the course of 10 to 14 days. Hearing was assessed immediately before therapy and within 1 to 2 wee ks after therapy. RESULTS: Hearing improvement was documented in 10 of 23 patients (44%) who underwent transtympanic steroid administration. This represents a 44% heari ng salvage in patients for whom steroid treatment would otherwise have been considered a failure. CONCLUSION: Transtympanic steroid therapy may be an alternative treatment f or patients with SSNHL for whom systemic steroid therapy had failed or who could not tolerate systemic steroid therapy.