Dexamethasone palmitate: A promising intratympanic treatment option for severe sudden hearing loss

Dexamethasone palmitate (DXP) is a lipophilic, esterified corticosteroid with sustained-release properties that may provide advantages over conventional water-soluble dexamethasone in intratympanic therapy for sudden sensorineural hearing loss (SSNHL). We report the safety and clinical outcomes of intratympanic DXP injection in three patients with profound SSNHL. All patients also received systemic steroids and hyperbaric oxygen therapy, along with six sessions of intratympanic DXP. Two patients demonstrated substantial improvement in hearing thresholds and speech discrimination within 3 months, whereas one patient who presented late showed no recovery. No adverse effects, such as pain, inflammation, or tympanic membrane complications, were observed. The increased viscosity and lipophilicity of DXP likely enhance cochlear drug delivery and prolong therapeutic retention. These findings suggest that DXP is a safe and potentially effective intratympanic option for SSNHL, particularly when administered early.