SYSTEMIC AND INTRATYMPANIC USE OF STEROIDS IN THE TREATMENT OF ACUTE SENSONEURAL DEAFNESS
DOI:
https://doi.org/10.32782/eddiscourses/2024-3-16Keywords:
sudden sensorineural deafness, steroids, intratympanic injection, combined therapy, audiogramAbstract
The Aim: to generalize the results of a comparative analysis of the therapeutic effectiveness of systemic and intratympanic administration of glucocorticosteroids with hyaluronic acid, as well as systemic administration of glucocorticosteroids in combination with nootropic drugs in the treatment of idiopathic sudden sensorineural deafness. Research methods and materials: comparative analysis, statistical analysis of the results of the study of the therapeutic effectiveness of systemic and intratympanic administration of glucocorticosteroids with hyaluronic acid, as well as systemic administration of glucocorticosteroids in combination with nootropic drugs in the treatment of idiopathic sudden sensorineural deafness. 49 patients with a history of idiopathic sudden sensorineural deafness were involved in the study. Three groups A (n = 17) were assigned intravenous dexamethasone; group B (n = 16) was administered intratympanic dexamethasone in combination with hyaluronic acid; C (n = 16 patients) dexamethasone was administered systemically in combination with nootropic drugs. Patients were monitored using audiograms on the 1st day (start of treatment) and on the 10th day. Results and Discussion. The final mean hearing gain was 29.0 dB HL for group A, 27.0 dB HL for group B, and 29.8 dB HL for group C. The differences between the three groups were not statistically significant. When hearing improvement was assessed by Siegel criteria, statistically significant differences were also not noted. In addition, patients younger than 50 years of age achieved significantly better results of hearing restoration. Conclusions. A comparative analysis of the results showed that systemic intravenous, combined intratympanic administration of steroids and hyaluronic acid, as well as intravenous administration of steroids in combination with nootropic drugs, have similar results in the primary treatment of sudden idiopathic deafness. Young patients achieve better hearing results earlier.
References
Ashtiani M.K., Firouzi F., Bastaninejad S., Dabiri S., Nasirmohtaram S., Saeedi N., et al. Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: A randomized controlled trial. Eur Arch Otorhinolaryngol. 2018. № 275. Р. 89–97.
Barreto M.A., Ledesma A.L., de Oliveira C.A., Bahmad F.Jr. lntratympanic corticosteroid for sudden hearing loss: Does it really work? Braz J Otorhinolaryngol. 2016. № 82. Р. 353–364.
Byl F.M., Jr. Sudden hearing loss: Eeight years’ experience and suggested prognostic table. Laryngoscope. 1984. № 94 (5 Pt 1). Р. 647–661.
De Kleyn A. Sudden complete or partial loss of function of the octavus-system in apparently normal persons. ActaOtolaryngol (Stockh). 1944. № 32. Р. 407–429.
Han X., Yin X., Du X., Sun C. Combined intratympanic and systemic use of steroids as a first-line treatment for sudden sensorineural hearing loss: A meta-analysis of randomized, controlled trials. Otol Neurotol. 2017. № 38. Р. 487–495.
Hobson C.E., Alexander T.H., Harris J.P. Primary treatment of idiopathic sudden sensorineural hearing loss with intratympanic dexamethasone. Curr Opin Otolaryngol Head Neck Surg. 2016. № 24. Р. 407–412.
Kitoh R., Nishio S.Y., Ogawa K., Kanzaki S., Hato N., Sone M., et al. Nationwide epidemiological survey of idiopathic sudden sensorineural hearing loss in Japan. Acta Otolaryngol. 2017. № 137. Supl. 565. Р. 8–16.
National Institute on Deafness and Other Communication Disorders (NIDCD) (2016) Sudden deafness. Accessed 10 March 2016.
Nosrati-Zarenoe R., Arlinger S., Hultcrantz E. Idiopathic sudden sensorineural hearing loss: Results drawn from the Swedish national database. Acta Oto-Laryngologica. 2007. № 127. Р. 1168–1175.
Qiang Q., Wu X., Yang T., Yang C., Sun H. A comparison between systemic and intratympanic steroid therapies as initial therapy for idiopathic sudden sensorineural hearing loss: A meta-analysis. Acta Otolaryngol. 2017. № 137. Р. 598–605.
Swachia K., Sharma D., Singh J. Efficacy of oral vs. intratympanic corticosteroids in sudden sensorineural hearing loss. J Basic Clin Physiol Pharmacol. 2016. № 27. Р. 371–377.
Wilson W.R., Byl F.M., Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A doubleblind clinical study. Acta Oto-Laryngologica. 1980. № 106. Р. 772–776.
Xie S., Qiang Q., Mei L., He C., Feng Y., Sun H., et al. Multivariate analysis of prognostic factors for idiopathic sudden sensorineural hearing loss treated with adjuvant hyperbaric oxygen therapy. Eur Arch Otorhinolaryngol. 2018. № 275. Р. 47–51.
Yang J., Wu H., Zhang P., Hou D.-M., Chen J., Zhang S.-G. The pharmacokinetic profiles of dexamethasone and methylprednisolone concentration in perilymph and plasma following systemic and local administration. Acta Otolaryngol (Stockh). 2008. № 128. Р. 496–504.
