Intratympanic Steroid Injection for Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) - An Emerging Therapy

INTRODUCTION: Idiopathic sudden sensorineural hearing loss is a very frightening condition as the patient suddenly realises hardness of hearing, most commonly after awakening in the morning. and incidence varies between five to ten per 100000 per year. Management of this disease is controversial. Most common mode of management is oral steroids for two to four weeks. Several drugs with different dose and duration has been tried with unsatisfactory results. So there is search for newer drugs/methods of management. Intratympanic dexamethasone injection is new in this field. OBJECTIVES: To find the effectiveness of intratympanic steroid injection (ITS) for hearing recovery and comparing the results with oral steroids therapy. MATERIALS AND METHODS: This study was done in the department of ENT, NRS Medical College, Kolkata, over a period of two years from January 2017 to December 2018. Total 64 patients of ISSHL was selected for the study. Through examination, otoscopy and pure tone audiometry was done for all the cases before initiation of therapy. Thirty patient received and thirty four patients received oral prednisolone for a protocol based dose and duration. Pure tone audiometry was repeated every two weeks over a duration of two months for documentation of improvement of hearing on pure tone four frequency average. RESULTS: Chances of recovery was more with intratympanic injection (70 %) in comparison to oral steroids (58.8 %). The ITS group showed faster recovery also with lower side effects. CONCLUSION: Intratympanic dexamethasone injection is more effective in comparison to oral prednisolone for the management of ISSHL. It is technically demanding.