Therapeutic effectiveness over time of intratympanic dexamethasone as salvage treatment of sudden deafness

Conclusion. Intratympanic dexamethasone (ITD) within 1 month after initial treatment failure should be utilized as salvage treatment for refractory sudden sensorineural hearing loss (SSNHL). Objective. To investigate the therapeutic efficacy over time of ITD as salvage treatment in SSNHL. Materials and methods. We retrospectively reviewed the medical records and audiograms of 99 SSNHL patients who were refractory to 2 weeks of oral steroid treatment, from August 2003 to October 2006. Patients were divided into those receiving no further treatment (control group) and those receiving ITD within 2 weeks (early-ITD), between 2 weeks and 1 month (mid-ITD), and between 1 and 2 months (late-ITD) after initial treatment failure. ITD was performed in the supine position on four separate occasions over the course of 2 weeks. Final assessment of hearing was carried out 3 months after outbreak of SSNHL. Hearing improvement was defined as a >15 dB decrease in four-tone average (FTA). Results. Overall hearing improvement was observed in 8 of 50 (16.0%) control patients, 7 of 16 (43.8%) early ITD patients, 6 of 20 (30.0%) mid ITD patients, and 2 of 13 (15.4%) late ITD patients.