Intratympanic injection of dexamethasone 4 mg/mL versus 10 mg/mL for management of idiopathic sudden sensorineural hearing loss

Background The aim of this study was to determine whether different concentrations of intratympanic (IT) injection of dexamethasone at a dose of 4 and 10 mg/mL have an effect on hearing outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Results Our study was conducted on 30 adult patients with unilateral ISSNHL who failed to respond or with contraindications to systemic steroids. Patients were categorized into two groups; each one included 15 patients. IT injection of 4 mg/mL dexamethasone was done in one group (IT dexamethasone (Dex) 4 mg/mL), while 10 mg/mL dexamethasone was administered intratympanically in the other group (IT Dex 10 mg/mL). IT injection was performed twice weekly for two successive weeks. PTA thresholds were assessed at 0.5, 1, 2 and 4 kHz before and 1 month after the treatment. In the group with IT Dex 10 mg/mL, the average PTA improved significantly from 75.50 +/- 12.59 to 49 +/- 24.04 dB with an average gain of 26.50 +/- 14.25 (p = 0.0007). In the group with IT Dex 4 mg/mL, there was a significant change of PTA from a pretreatment value of 76.92 +/- 11.89 dB to a post-treatment value of 59.27 +/- 92.10 dB with an average gain of 17.65 +/- 8.36 dB. A comparison of the post-treatment gain of PTA in both groups showed better improvement of hearing in a group treated by IT Dex 10 mg/mL compared with 4 mg/mL. Conclusion This study demonstrated that IT injection of dexamethasone at a dose of 10 mg/ml was associated with better hearing outcomes compared with 4 mg/mL for the treatment of ISSNHL.