Clinical efficacy of initial intratympanic steroid treatment on sudden sensorineural hearing loss with diabetes

Abstract

Objective: The purpose of this study is to compare the efficacy of intratympanic steroid injection (ITSI) with that of systemic steroids as an initial treatment of sudden sensorineural hearing loss (SNHL) with diabetes. Study Design: Prospective, nonrandomized multicenter clinical trial. Setting: Multicenter study in Busan and Masan, South Korea. Subjects and Methods: A total of 114 sudden SNHL patients who were diagnosed with diabetes were divided into peroral (PO) group (n = 48), intravenous (IV) group (n = 32), and intratympanic (IT) group (n = 34). In the PO group, prednisolone was used orally for 10 days, per schedule. In the IV group, prednisolone was administered intravenously for seven days, followed by oral administration of tapered doses for another several days. In the IT group, dexamethasone was injected into the tympanic cavity four times within a two-week period. Hearing outcome was assessed before and after the treatment. Results: All groups showed significant improvement with criteria of 15 dB ( P < 0.05). However, there was no significant difference in hearing gain and recovery rate among groups ( P > 0.05). Systemic steroid treatment was stopped for two patients in the IV group and for one in the PO group due to uncontrolled hyperglycemia. However, in the IT group, there were no patients who failed to control their blood sugar level. Conclusion: ITSI is as effective as systemic steroid treatment for sudden SNHL patients with diabetes and it can avoid undesirable side effects. Therefore, we consider ITSI to be a more reasonable alternative as an initial treatment for sudden SNHL patients with diabetes.