Treatment of idiopathic neurosensory Hearing Loss remains controversial and lacks a universally accepted treatment protocol. Nonetheless, many proprietary medicinal products have been used to improve the prognosis of patients such as, glucocorticoids, antivirals, anticoagulants, vasodilators and anti-inflammatory agents as well as the use of hyperbaric oxygen.

Treatment with intra-tympanic steroids for Sudden Hearing Loss:

The use of steroids for intratympanic administration is indicated for patients who cannot tolerate systemic administration of steroids, for patients with diabetes mellitus, immunosuppressed patients, or for patients infected with tuberculosis or HIV.

Systemic administration of steroids is the basis of SSHL treatment. However, prolonged use of high doses of steroids has significant undesirable gastrointestinal, musculoskeletal, dermatological, neurological, ophthalmological, endocrinological and metabolic complications.

Hearing Loss.ent

Hearing Loss

The main benefits of intra-tympanic steroid administration:

  • Tolerable and relatively easy process for implementation
  • A high concentration of the active substance is available directly to the affected ear
  • Unlike systemic administration, topical steroid infusion selects the affected ear
  • Rare side effects or complications
  • Only the application of a local anesthetic is required
References
  • Nevoux J, Barbara M, Dornhoffer J, Gibson W, Kitahara T, Darrouzet V. International consensus (ICON) on treatment of Ménière’s disease. Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Feb;135(1S):S29-S32.
  • Nyberg S, Abbott NJ, Shi X, Steyger PS, Dabdoub A. Delivery of therapeutics to the inner ear: The challenge of the blood-labyrinth barrier. Sci Transl Med. 2019 Mar 06;11(482.
  • Lukashkin AN, Sadreev II, Zakharova N, Russell IJ, Yarin YM. Local Drug Delivery to the Entire Cochlea without Breaching Its Boundaries. iScience. 2020 Mar 27;23(3):100945.
  • Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA, Hollingsworth DB, Kelley DM, Kmucha ST, Moonis G, Poling GL, Roberts JK, Stachler RJ, Zeitler DM, Corrigan MD, Nnacheta LC, Satterfield L. Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngol Head Neck Surg. 2019 Aug;161(1_suppl):S1-S45