Intratympanic dexamethasone for sudden sensorineural hearing loss: Clinical and laboratory evaluation

Objective: To discuss the value of intratympanic dexamethasone (IT-DEX) perfusion for sudden sensorineural hearing loss (SSNHL), clinically and in an animal model. Study Design: Retrospective case review of 10 patients with SSNHL treated with IT-DEX. The findings are correlated with this institution's previous findings 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 bathed the round window for 20 minutes. Animal study: 79 ears were randomized into five groups: control, IT-DEX versus intravenous (IV)-DEX, IT-DEX with histamine, IT-DEX with hyaluronic acid, and IT-DEX with dimethylsulfoxide. Main Outcome Measures: Clinical study: postprocedure audiometry. Animal study: perilymph steroid concentration. Results: IT-DEX results in significant hearing improvement and in significantly 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 warranted.