Systemic steroid therapy has been considered a mainstay for treat
ment qfidiopathic sudden sensorineural hearing loss (ISSNHL), specially
among those who suspect a viral etiology. Unfortunately, some patients
are poor candidates for systemic steroids. The aim of the present study is
to evaluate the efftcacy of intratympanic dexamethasone injection for
diabetic and hypertensive patients with SSNHL in whom systemic ster
oid therapy is hazardous. This study was undertaken prospecttvely on
26 diabetic and hypertensive patients with unilateral moderately severe
and severe SSNHL in whom there was a history of a recent upper respira
tory tract infection. The patients were 14 men (53.8%) and 12 women
(46.2%) with an age range 43-68 years. Under local anaesthesia, 0.5.ml
of dexamethasone (24 mg/ml) was injected in the tympanic cavity, injec
tion was performed on three separate occasions over 10 days. Hearing
was assessed by pure-tone and speech audiometry immediately before,
twice weekly during therapy and within 3 weeks after therapy was dis
continued. Pure-tone average (500, 1000 and 2000Hz) improved in 15
patients (57.7%). 7patients (27%) recovered to normal hearing threshold
levels , 5 patients (19.2%) improved to a degree of mild hearing loss and 3
patients (11.5%) improved to a degree of moderate hearing loss. A hear
ing recovery rate of 57.7% in ISSNHL could be considered a good and
encouraging response rate in a group of patients who can not tolerate
systemic steroid therapy and may be considered beyond therapeutic
reach. |
