Results of Intratympanic Dexamethasone Injection as Salvage Treatment in Idiopathic Sudden Hearing Loss

Objective: To evaluate the efficacy of intratympanic (IT) dexamethasone injection as a salvage treatment in idiopathic sudden hearing loss (ISHL) patients. Design: A prospective study. Setting: A secondary care hospital. Methods: Fifty-two subjects whose pure-tone averages (PTAs) after a 2-week standard treatment were. 30 dB or worse than 10 dB from the contralateral ear were included. Thirty-four patients underwent IT dexamethasone injection and 18 patients (control) received no further treatment. Final hearing outcome was compared between the two groups. Main Outcome Measures: At 2 weeks after IT dexamethasone injection, audiograms were obtained and compared between the two groups. Results: Sixteen patients (47.1%) in the IT dexamethasone group and 8 patients (44.4%) in the control group finally showed an improvement of 10 dB or more in PTA or a 15% or more change in speech discrimination score (p>.05). The average improvement in PTAs was 8.2 dB in the IT dexamethasone group and 3.6 dB in the control group (p = .184). Patients responsive to the initial treatment showed better final outcomes, irrespective of IT dexamethasone injection. Conclusions: The present study does not support IT dexamethasone injection as a beneficial salvage treatment for ISHL patients. The true efficacy of this procedure still needs to be investigated.