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Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss

Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss

Published on: January 25, 2016

Intratympanic corticosteroids for sudden sensorineural hearing loss.

Stefan K Plontke¹, Christoph Meisner², Sumit Agrawal³

¹Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.

The Cochrane Database of Systematic Reviews

|July 22, 2022

Summary

This summary is machine-generated.

Intratympanic corticosteroids show limited benefit for idiopathic sudden sensorineural hearing loss (ISSNHL) as primary treatment but may improve hearing when used as secondary therapy. Further research is needed due to low-certainty evidence and potential adverse effects like ear pain and dizziness.

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Area of Science:

Otolaryngology
Audiology
Pharmacology

Background:

Idiopathic sudden sensorineural hearing loss (ISSNHL) is a common condition of unknown cause.
Systemic corticosteroids are a standard treatment, but their efficacy is debated.
Intratympanic corticosteroid injections are increasingly used for ISSNHL.

Purpose of the Study:

To evaluate the effectiveness of intratympanic corticosteroids for treating ISSNHL.
To compare intratympanic corticosteroids with systemic corticosteroids and placebo/no treatment.
To assess various outcomes including hearing threshold changes and adverse effects.

Main Methods:

Systematic review and meta-analysis of randomized controlled trials (RCTs).
Included 30 studies with 2133 participants comparing intratympanic corticosteroids (primary or secondary therapy) with other treatments.
Primary outcome was hearing threshold change; secondary outcomes included hearing improvement rates and adverse events.

Main Results:

As primary therapy, intratympanic corticosteroids showed little to no improvement in hearing compared to systemic corticosteroids, with increased risk of ear pain and dizziness.
Combined intratympanic and systemic therapy may offer a small benefit over systemic therapy alone, but evidence is uncertain.
As secondary therapy, intratympanic corticosteroids showed low-certainty evidence of improved hearing outcomes compared to no treatment/placebo, with potential adverse effects.

Conclusions:

Evidence for intratympanic corticosteroids in ISSNHL is mostly low or very low certainty.
Intratympanic therapy may be beneficial as secondary treatment but offers limited advantages as primary therapy.
Adverse effects of both intratympanic (perforation, pain, dizziness) and systemic (e.g., glucose issues) treatments should be considered.