Course and prognosis analysis of intratympanic dexamethasone in the treatment of sudden sensorineural hearing loss

Objective: To compare the recovery of different times of intratympanic dexamethasone in the treatment of sudden sensorineural hearing loss(SSNHL) and investigate the related prognostic factors. Method: Ninety patients with SSNHL were randomly divided into group A(3 times, every 2 days) and group B(5 times, every 2 days) according to the times of intratympanic dexamethasone. All patients were treated with blood flow promoting agents and neural nutrients. After 2 weeks of treatment, the recovery was compared. Based on treatment outcomes, patients were divided into two groups: recovery and no recovery, we evaluated the possible prognostic factors. Result:In the group A, the threshold improvement was(20.2±16.7) dB HL and the overall recovery rate was 78.7%(complete recovery rate, marked recovery rate and recovery rate were 17.0%, 21.3% and 40.4%, respectively), in the group B, the threshold improvement was(20.4±17.4) dB HL and the overall recovery rate was 81.4%, the complete recovery rate, marked recovery rate and recovery rate were 20.9%, 32.6% and 27.9%, respectively, the differences of recovery variables between the 2 groups were not statistically significant. After 2 weeks of treatment, 71 patients got overall recovery(78.9%), 19 patients(21.1%) resulted in no recovery, Interval between onset of symptoms and therapy of recovery group was shorter than that in no recovery group ［(5.6±3.6）days vs. （7.7±4.0）days, P<0.05］, the presence rate of vertigo in recovery group was lower than that in no recovery(14.1% vs. 68.4%, P<0.01). Gender, ear side, age, concurrence of tinnitus, initial hearing threshold, times of intratympanic dexamethasone and audiogram have no influence on the prognosis of SSNHL.

Conclusion: SSNHL patients treated with 3 times and 5 times of intratympanic dexamethasone got similar results. Earlier treatment and absence of vertigo lead to favorable hearing results.