Abstract
Objectives:
Sensorineural hearing loss associated with acute otitis media (acute infective sensorineural hearing loss [AISNHL]) is a well-recognized but rare phenomenon with no accepted treatment pathway. Our objectives were to (1) evaluate the effects of intratympanic steroid (ITS) administration on AISNHL and (2) analyze factors which may be associated with a favorable outcome following ITS.
Methods:
A retrospective case note review of 7 consecutive patients (5 men, 2 women) seen between November 2006 and October 2013 and diagnosed with AISNHL was performed. Patients were prescribed 7 days of oral antibiotics and prednisolone and offered ITS thereafter if there was no improvement. Up to 3 intratympanic injections of methylprednisolone (40 mg/mL) were administered.
Results:
Patients were considered to have a significant improvement in their hearing if average change in threshold was equal to or greater than 10 dB following ITS. This was the case in 57% (4/7) of patients. The mean improvement in threshold was 24 dB (range 10-52 dB) in these responders. Three-fourths of responders had a mild high frequency hearing loss. Responders had a smaller sensorineural loss at presentation (responders mean 39 dB pre-ITS,15 dB post-ITS; nonresponders mean 65 dB pre-ITS, 83 dB post-ITS), presented earlier (4 days, range 3-6 days versus 12 days, range 2-21 days) and received their first ITS earlier (24 days, range 13-37 days versus 35 days, range 24-42 days) than nonresponders.
Conclusions:
ITS may provide a valuable contribution to the treatment of SNHL in acute otitis media. A larger study looking at timing of intratympanic administration after antibiotics and/or oral steroid treatment would be beneficial.
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