[Intratympanic dexamethasone for refractory sudden deafness].

Area of Science:

• Otolaryngology
• Neurology
• Pharmacology

Background:

• Sudden deafness (SD) presents a significant audiological challenge, particularly in cases resistant to or contraindicated for systemic steroid treatment.
• Systemic corticosteroids are a primary treatment for SD, but their efficacy is limited in certain patient groups and can be associated with adverse effects.

Purpose of the Study:

• To evaluate the clinical effectiveness and safety of intratympanic dexamethasone (IT-DEX) in patients with sudden deafness who are unresponsive or contraindicated for systemic steroids.
• To assess the impact of IT-DEX on auditory function, tinnitus, and aural fullness in this patient cohort.

Main Methods:

• A cohort of 34 patients with sudden deafness, unsuitable for systemic steroids, received IT-DEX (5 g/L) administered four times within a 12-day period.
• Improvements in hearing, tinnitus, and aural fullness were monitored. Statistical analysis was employed to compare outcomes based on influencing factors like age, sex, and disease duration.

Main Results:

• Overall efficacy rates for hearing, tinnitus, and aural fullness were 52.9%, 58.8%, and 82.4%, respectively.
• Patients treated within two weeks showed a trend towards better auditory and tinnitus improvement compared to those treated later, though not statistically significant (P >0.05).
• For patients unresponsive or contraindicated to systemic steroids, the audible effective rates were 44.4% and 62.5%, respectively.

Conclusions:

• Intratympanic dexamethasone (IT-DEX) demonstrates significant efficacy and a favorable safety profile for treating refractory sudden deafness.
• IT-DEX serves as an effective therapeutic option for patients with contraindications to systemic steroids and a viable salvage treatment for those unresponsive to systemic therapy.