Bigyan Raj Gyawali, Rabindra Bhakta Pradhanaga, Pabina RayamajhiIndian Journal of Otology 2021 27(1):36-39
Introduction: The steroid is the drug of choice in patients with sudden sensorineural hearing loss (SSNHL). Thirty to fifty percent of cases, despite receiving steroids may have incomplete recovery. Furthermore, there are a significant number of patients in whom systemic steroids are contraindicated such as cases with uncontrolled diabetes, uncontrolled hypertension, and pregnancy. Intratympanic steroids can play a vital role as salvage therapy in these cases. The aim of this study was to evaluate the effectiveness of intratympanic Dexamethasone as salvage therapy in cases who fail to respond with systemic steroids, who present late (>1 week) after the onset of symptoms and cases, in whom systemic steroids are contraindicated. Materials and Methods: This was a retrospective study conducted in the Department of ENT-Head and Neck Studies, T.U. Teaching Hospital, Kathmandu, Nepal. Approval from the Institutional Review Committee was taken. A prospectively set record data of cases wit h SSNHL receiving intratympanic Dexamethasone as a salvage therapy from April 2018 to April 2020 were analyzed for improvement in hearing outcome. We used SPSS version 25 for the statistical analysis. Chi-square test and Fisher's exact test were used to draw statistical co-relation. Value of P < 0.05 was considered statistically significant. Results: A total of 34 cases met the inclusion criteria. M: F was 3:1 with the majority of cases in the third–fifth decades of life. A total of 11 cases showed partial improvement and one case had complete improvement. There was no statistically significant co-relation between hearing outcome and time interval (from the onset of symptoms to intratympanic injection), level of hearing loss, comorbidities, and prior use of systemic steroid therapy (P > 0.05). Conclusion: Intratympanic Dexamethasone has audiological benefits as a salvage therapy in cases with SSNHL failing to respond with systemic steroid therapy.
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