gms | German Medical Science

78. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

16.05. - 20.05.2007, München

Intratympanic Cortison Application for Sudden Hearing Loss

Meeting Abstract

Suche in Medline nach

  • corresponding author Andreas Glowania - Klinik für HNO und Kommunikationsstörungen, Koblenz, Germany
  • author Jan Maurer - Klinik für HNO und Kommunikationsstörungen, Koblenz, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Munich, 16.-20.05.2007. Düsseldorf, Köln: German Medical Science; 2007. Doc07hno004

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2007/07hno004.shtml

Veröffentlicht: 8. August 2007

© 2007 Glowania et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background and objective: As a gold standard in first line therapy intravenous or oral application of corticoids is often effective, but sometimes fails.

The aim of our investigation was to analyze the effect of Intratympanic injection of corticoids (IT) as an additive of classic infusion schemes in the primary therapy and as second line treatment in sudden sensorineural hearing loss (SSNHL) and rapid progredient hearing loss (RPHL) .

Study design: We performed a retrospective analysis of 56 cases with sudden sensorineural hearing loss (SSHL) and rapid progredient hearing loss who were treated in our department between 10/2003 – 12/2006. In the first group we included patients with a minimum hearing loss of 60 dB or more at one or more frequencies. They were treated with Prednison, Pentoxifyllin and HAES. Additionally they received Intratympanic Dexamethason with Hyaloronic acid each second day. In the second group patients after any kind of failed first line treatment went IT as an outpatient procedure. The first group consisted of 41 patients (23 female, 18 male) with a mean age of 58,4 years, in the other group 15 patients (7 female, 8 male; mean age = 51,33 years) were treated. Patients in both groups were injected intratympanically : 0,5 ml of a solution with Dexamethason 4 mg / Hyaloronic acid 0,1 mg (mean average of injections group 1 : 5,98 vs. 6,3 group 2 ). Before each injection a puretone audiogram was performed (250, 500, 1000, 2000, 4000 and 6000 Hz).

Results: There was no systemic side effect, ear infection or persistent perforation of the ear drum. We found hearing improvement in the first group ranging between 13 and 21 dB with maximum effect at 4000 Hz. In the outpatient group the improvement was between 4 and 11 dB ( maximum at 250 / 500 Hz). The improvement for the mean of 500, 1000, 2000 and 4000 Hz in the first group was 14 dB and 8,5 dB in the second group.

Conclusion: Intratympanic injection of Corticoids is a safe procedure with no systemic side effects. In our opinion patients with acute hearing loss and classic infusion therapy profit from additionally IT. Also patients after failed outpatient therapy should be treated with IT.