Role of Transtympanic Steroid in Sudden Sensorineural Hearing Loss: A Retrospective Study

Abstract

Introduction: Sudden Sensorineural Hearing Loss (SNHL) is medical emergency in otology. The diagnosis and treatment of sudden SNHL remains a matter of discussion as no single treatment is gold standard. Antivirals, systemic and intratympanic steroids, vasodilators, antioxidants and hyperbaric oxygen therapy are a few treatment options for sudden SNHL. Aim: To assess role of transtympanic steroid in sudden SNHL cases in view of frequency specific gain and average hearing gain. Materials and Methods: A retrospective cross-sectional study was conducted in Otorhinolaryngology Department of a tertiary teaching hospital, in which records of total 27 patients with diagnosis of sudden SNHL from 1st January 2019 to 31st December 2020 were analysed. All enrolled patient underwent pure tone audiometry before treatment, after 3rd transtympanic injection and On 7th day follow-up. post follow-up. All patient received three transtympanic 0.5 mL methyl prednisolone injection on day 1, day 3 and day 5 of treatment. Pretreatment and post-treatment frequency specific hearing threshold and frequency specific hearing gain along with average hearing gain were assessed. Statistical analysis was done using student paired t-test independent t-test and one-way Analysis of Variance (ANOVA) test. Results: Total 35 case ears were analysed among 27 patients as 8 patients had bilateral sudden SNHL. Average gain for frequency 250 Hz, 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz were 18 dB, 25 dB, 27 dB, 28 dB and 30 dB, respectively. There was average 42% audiometric gain in hearing after transtympanic steroid injection. Cases who received treatment within four days had average gain of 48.5% while those who came after four days had average hearing gain of 39%. Hearing gain in 40 years was 44.3% and 41.8% respectively. Hearing gain in bilateral ear was 42.9% and in unilateral ear was 43.5%. Conclusion: Sudden SNHL has high emotional and social impact on patient and family as it has influence on life quality. Transtympanic steroid injection promises good outcome in all patients with sudden SNHL. However, early diagnosis and early management of sudden SNHL is the key in significant success.

Keywords

• audiometric gain
• frequency specific gain
• intratympanic
• methyl prednisolone
• otology