Comparative Study Between Intratympanic Methylprednisolone Injection versus Dexamethasone for the Treatment of Idiopathic Sudden Sensorineural Hearing Loss

Document Type : Original Article

Authors

1 Otorhinolaryngology department, Faculty of Medicine, Beni-Suef University, Egypt

2 Audio-Vestibular Medicine department, Faculty of Medicine, Beni-Suef University, Egypt

Abstract

Background: Idiopathic sudden sensorineural hearing loss (ISSHL) continues to be a medical mystery, both in terms of its cause and its therapy. Corticosteroids are supposed to aid ISSHL healing because of their anti-inflammatory effects. In this study, we compared the effectiveness of two steroid treatments for ISSHL: methylprednisolone (40 mg/mg) and dexamethasone (24 mg/ml). Methods: In a randomized, interventional study, we recruited 40 patients with ISSHL. Patients were randomly allocated to group (A) received injection of 1 ml Dexamethasone (24mg/ml) in the middle ear cavity and group (B) Injection of 1ml of Methylprednisolone (40 mg/ml) in the middle ear cavity, every patient in each group was injected 5 times in consecutive days and PTA and tympanometry done 3days,5 days, and 6weeks postoperatively. Results: There was statistically insignificant higher complete and partial recovery in Methylprednisolone than Dexamethasone groups. In methylprednisolone group (17.4%) showed partial recovery compared to (16%) in dexamethasone group. Also, (21.7%) in methylprednisolone group showed complete recovery compared to (12%) in dexamethasone group. The mean speech discrimination after injection was 74.3%±19.3% in methylprednisolone group and 69.6%±31.6% in dexamethasone group. There was insignificant improvement in speech discrimination in both groups however, the absolute mean difference was higher in Methylprednisolone than Dexamethasone group.  Conclusions: With a poor likelihood of recovery, idiopathic sudden sensorineural hearing loss continues to be a difficult clinical issue. Intratympanic steroid injection, however, is a comparatively efficient, secure, and well-tolerated method for the treatment of ISSHL. Results related to hearing loss strongly recommend using methylprednisolone intratympanic injection rather than dexamethasone.

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References

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