by

Gerard J. Gianoli, M.D.and John C. Li, M.D., 

Presented at the Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery, September 26-29, 1999, New Orleans, Louisiana.

Objectives: The standard medical regimen for sudden onset sensorineural hearing loss (SSNHL) usually involves systemic steroid therapy. Unfortunately, some patients do not respond successfully or are poorly tolerant of systemic steroids. Transtympanic administration of steroids has been suggested as an alternative to systemic therapy. The purpose of this study is to determine whether transtympanic steroid administration may be an effective treatment for SSNHL in patients who have failed systemic steroid treatment or who were not candidates for systemic steroids.

Methods: A prospective study was designed to evaluate the hearing outcomes in SSNHL patients treated with transtympanic steroids. Patients who received transtympanic steroids either failed, or were not able to tolerate oral steroids. Transtympanic steroids were administered through a ventilation tube place under local anesthesia. Steroid administration was performed on 4 separate occasions over the course of 10-14 day. Hearing was assessed immediately prior to therapy and within 1-2 weeks after therapy.

Results: Hearing improvement was documented in 10 of 23 patients (44%) who underwent transtympanic steroid administration. This represents a 44% hearing salvage in patients that would have otherwise been considered steroid treatment failures.

Conclusion: Transtympanic steroid therapy may be an alternative for treatment for patients with SSNHL who have failed or cannot tolerate systemic steroid therapy.