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Intratympanic steroids

Michael C Topf, David W Hsu, Douglas R Adams, Tingting Zhan, Stanley Pelosi, Thomas O Willcox, Brian McGettigan, Kyle W Fisher
PURPOSE: To determine the rate of persistent tympanic membrane perforation after intratympanic steroid injection. To determine which comorbid conditions and risk factors are associated with prolonged time to perforation closure following intratympanic steroid injection. MATERIALS AND METHODS: Clinical data were gathered for patients who had undergone intratympanic steroid injection to treat sudden sensorineural hearing loss or Ménière's disease. Primary outcomes analysis included rate of persistent tympanic membrane perforation, defined as perforation at least 90days following last injection, and time to perforation healing...
September 28, 2016: American Journal of Otolaryngology
J M Espinosa-Sanchez, J A Lopez-Escamez
Menière's disease (MD) is a chronic multifactorial disorder of the inner ear characterized by episodic vestibular symptoms associated with sensorineural hearing loss, tinnitus, and aural pressure. Epidemiologic and genomic evidence supports a genetic susceptibility with multiple biochemical pathways involved, including the endocrine system, innate immune response, and autonomic nervous system. Allergens, infectious agents, vascular events, or genetic factors could modify inner-ear homeostasis and trigger MD...
2016: Handbook of Clinical Neurology
Koichiro Wasano, Shuta Tomisato, Sayuri Yamamoto, Noriomi Suzuki, Taiji Kawasaki, Kaoru Ogawa
OBJECTIVE: To report the treatment efficacy of continual intratympanic steroid injection (ITSI) therapy in a patient with refractory sensorineural hearing loss accompanied by relapsing polychondritis. PATIENT: A 49-year-old female diagnosed with relapsing polychondritis at the age of 45 years and who had been treated with corticosteroids and immunosuppressants developed sensorineural hearing loss in the left ear. INTERVENTION: Her unilateral hearing loss did not recover despite receiving one cyclophosphamide pulse treatment, one methylprednisolone pulse treatment, and weekly leukapheresis...
August 20, 2016: Auris, Nasus, Larynx
Kavita Dedhia, David H Chi
OBJECTIVES: 1. To report our experience in children with sudden-onset sensorineural hearing loss (SSNHL). 2. To describe the etiology and management of children with SSNHL. METHODS: Retrospective review of 20 children with SSNHL, from 2000 to 2013 at a tertiary pediatric facility. Patients had the following inclusion criteria: history of normal hearing, hearing loss occurring in less than 3 days, and audiogram documentation. RESULTS: The average age of patients presenting with SSNHL is 11 years 3 months (22months-18years)...
September 2016: International Journal of Pediatric Otorhinolaryngology
Hazem Saeed Amer, Mohammad Waheed El-Anwar, Alaa Eldin Elfeky
INTRODUCTION: Otitis media with effusion (OME) is a leading cause of hearing impairment in children. Therefore, early and proper management is essential. OBJECTIVES: The objective of this research is to assess the efficacy of intratympanic (IT) steroids injection for management of otitis media with effusion (OME). METHODS: This study involved 42 children (84 ears) with bilateral OME. We used tympanometry to confirm the childreńs middle ear effusion and pure tone audiometry to determine hearing threshold...
July 2016: International Archives of Otorhinolaryngology
Nezamoddin Berjis, Saeed Soheilipour, Alireza Musavi, Seyed Mostafa Hashemi
BACKGROUND: During the past years various drugs have been used for sudden sensorineural hearing loss (SSNHL) treatment including steroids that are shown to be beneficial. Directed delivery of high doses of steroids into the inner ear is suggested for its potential and known as intratympanic steroids therapy (IST). Despite the use of dexamethasone and methylprednisolone as the traditional treatments, there are still debates about the optimal dosage, preferred drug, and the route of administration...
2016: Advanced Biomedical Research
Denis S Uffer, Stefan C A Hegemann
OBJECTIVE: To determine whether patients with acute unilateral peripheral vestibulopathy (PVP), often called "vestibular neuritis/neuronitis or neuropathy" (VN) have a vestibular lesion pattern consistent with the distribution of the neurological afferents. BACKGROUND: Much is known about the clinical nature of PVP, however less so about its etiology and pathogenesis. Due to the frequency with which VN is used to describe the syndrome, an inflammation of the vestibular nerve or of one of its branches is often assumed to be the cause of PVP, though there is insufficient data so far to support this assumption...
July 2, 2016: Journal of Vestibular Research: Equilibrium & Orientation
Aaron M Metrailer, Seilesh C Babu
PURPOSE OF REVIEW: Sudden sensorineural hearing loss (SNHL) is an otologic emergency and should be managed quickly and effectively. This review focuses on the management of sudden SNHL, primarily idiopathic sudden SNHL as it is the most common cause. RECENT FINDINGS: Management options include observation, oral steroids, intratympanic steroids, or combined oral/intratympanic steroids. One-third to two-thirds of patients will achieve spontaneous recovery, most likely within the first 2 weeks...
October 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Candace E Hobson, Thomas H Alexander, Jeffrey P Harris
PURPOSE OF REVIEW: Systemic corticosteroids have been the mainstay of treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) for over 30 years. Recently, intratympanic steroids have risen in popularity; however, there is no consensus regarding the details of their application. The purpose of this article is to review the current literature and share our opinion that intratympanic dexamethasone (alone or with systemic steroids) should be offered as primary treatment of ISSNHL...
October 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Brendan P O'Connell, Jacob B Hunter, David S Haynes
PURPOSE OF REVIEW: The purpose of this manuscript is to review the initial management strategies for idiopathic sudden sensorineural hearing loss, with an emphasis on the role that steroids play in treatment of this condition, and discuss options for auditory rehabilitation of persistent unilateral hearing loss. RECENT FINDINGS: Recent data suggest that hearing improvement may be greater for patients initially treated with both systemic and intratympanic steroid when compared with those treated with systemic steroids alone...
October 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Gültekin Övet, Necat Alataş, Fatih Güzelkara
OBJECTIVE: The aim of the present study was to compare hearing improvements obtained with combined intratympanic and systemic steroid therapy, and systemic steroid therapy alone in pediatric patients with idiopathic sudden sensorineural hearing loss (SSHL). STUDY DESIGN: Retrospective. SETTING: Tertiary referral hospital. PATIENTS: Pediatric patients with SSHL. INTERVENTIONS: The patients were divided into two groups, based on the method of steroid administration: Group 1 (systemic therapy group, n = 23) was treated with oral methylprednisolone alone whereas Group 2 (combination therapy group, n = 26) was treated with combination of oral methylprednisolone and intratympanic dexamethasone injections...
July 2016: Otology & Neurotology
R L Heywood, S N Ifeacho, A A Narula
OBJECTIVE: To evaluate a small cohort of patients who presented with symptoms and signs consistent with acute infective sensorineural hearing loss who were treated with intratympanic steroids. METHOD: Seven patients received a 7-day course of oral antibiotics and oral prednisolone followed by 3 intratympanic injections of methylprednisolone and 1 week of topical dexamethasone drops. RESULTS: Hearing improved in 57 per cent of patients (four out of seven)...
June 2016: Journal of Laryngology and Otology
Shinya Morita, Yuji Nakamaru, Keishi Fujiwara, Keiji Iizuka, Masayori Masuya, Akihiro Homma, Atsushi Fukuda, Satoshi Fukuda
OBJECTIVES: To evaluate the hearing outcomes of intratympanic steroid (ITS) treatment for patients with acute low-tone sensorineural hearing loss (ALHL) after failure of initial therapy and to investigate the recurrence and progression to definite Ménière's disease (MD) during a long-term follow-up. METHODS: We retrospectively reviewed the medical records of 90 patients with refractory ALHL who were followed up for at least 1 year between January 2000 and April 2014...
2016: Audiology & Neuro-otology
Yang Gao, Dong Liu
The main objective of the meta-analysis was to investigate whether intratympanic steroid injections in combination with systemic steroids would provide an additional advantage over systemic steroid therapy (SST) alone in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). The results will provide a meaningful suggestion in clinical therapy of ISSNHL. The electronic database search was based on the database in OVID Medline, Embase and PubMed up to December 15, 2015 with the goal of identifying all available observational studies examining the effects of combination therapy and SST in ISSNHL patients...
April 12, 2016: European Archives of Oto-rhino-laryngology
Hans Lamm, Claus Müller-Kortkamp, Athanasia Warnecke, Friederike Pohl, Gerrit Paasche, Thomas Lenarz, Stefan R O Stolle
Concurrent hyperbaric oxygen therapy (HBOT) and intratympanic steroid application (ITS) are beneficial as salvage therapy for therapy-refractory sudden sensorineural hearing loss (SSNHL). The findings encourage further research on the treatment of noise-induced and idiopathic SSNHL with concurrent use of HBOT and ITS respecting also patients with long-term or therapy-refractory SSNHL.
March 2016: Clinical Case Reports
Jingcai Chen, Jun Yang, Huan Jia, Jun Shi, Yun Li, Hao Wu
OBJECTIVE: To observe the efficacy of intratympanic steroid injection as supplementary or initial treatment for sudden sensorineural hearing loss (SSNHL). METHOD: A total of 68 patients diagnosed with SSNHL were randomized into group A (45 cases including systemic steroid for 33 cases and systemic steroid + intratympanic steroid as supplementary treatment for 12 cases) and group B (23 cases, initial intratympanic steroid). Then observe the therapeutic effect in two groups...
October 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Da Jung Jung, Ji Hye Park, Jeong Hun Jang, Kyu-Yup Lee
OBJECTIVES/HYPOTHESIS: The aim of this study was to compare the hearing results of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) who initially were treated with either a combination therapy of systemic steroids (SS) and intratympanic steroid injection (IT-S) or SS only. METHODS: The study followed a retrospective case-control design. One-hundred five patients who were diagnosed with ISSNHL and required treatment via admission were enrolled in this study...
August 2016: Laryngoscope
Peng Chen, Shifei Wang, Yu Zhang, Han Huang, Chunlin Zhang, Zheng Xiao
OBJECTIVE: To assess the efficacy and safety of glucocorticoid in initial treatment of sudden hearing loss with intratympanic (IT) and systemic ways. METHOD: We searched the database of PubMed, Cochrane, Embase,CBM, CNKI, VIP, Wanfang systematically. Literatures were screened according to the preestablished inclusion and exclusion standards,and all the RCT literatures associated with intratympanic and systemic glucocorticoid in the initial treatment of sudden hearing loss before may 2015 were collected...
November 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Hideaki Suzuki, Hiroki Koizumi, Jun-Ichi Ohkubo, Nobusuke Hohchi, Shoji Ikezaki, Takuro Kitamura
We studied the effect of intratympanic steroid administration with different intervals on hearing outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). The subjects were 197 consecutive patients (197 ears) with ISSNHL (hearing level ≥40 dB, interval between onset and treatment ≤30 days). They received systemic administration of prednisolone (100 mg followed by tapered doses) combined with intratympanic injection of dexamethasone (4 mg/ml). Intratympanic injection was performed once a week for 4 weeks in 105 patients (long-interval group), or 4 times in 1 week in 92 patients (short-interval group)...
October 2016: European Archives of Oto-rhino-laryngology
Monique Antunes de Souza Chelminski Barreto, Aleluia Lima Losno Ledesma, Carlos Augusto Costa Pires de Oliveira, Fayez Bahmad
INTRODUCTION: Sudden deafness is characterized by an abrupt hearing loss of at least 30dB in three sequential frequencies in the standard pure tone audiogram over three days or less. Treatment is based on its etiology, and oral corticosteroids are widely used. Intratympanic corticosteroids are included as primary or secondary treatment when there is no improvement with the use of oral corticosteroids. OBJECTIVE: To determine the effectiveness of therapy with intratympanic steroids in sudden deafness...
May 2016: Brazilian Journal of Otorhinolaryngology
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