Kemal KESEROĞLU, Gökhan TOPTAŞ, Ahmet ULUAT, Ömer BAYIR, Emel Çadallı TATAR, Güleser SAYLAM, Mehmet Hakan KORKMAZ, Ali ÖZDEK

Addition of intratympanic steroid or hyperbaric oxygen treatment to systemic steroid treatment in sudden idiopathic sensorineural hearing loss treatment, and long-term results of salvage treatment

Background/aim: This study aims to determine the therapeutic superiority of the addition of intratympanic steroid or hyperbaric oxygen therapy to systemic steroid treatment in idiopathic sudden sensorineural hearing loss as initial treatment, and evaluate the long-term results of salvage treatment. Materials and methods: This study was a retrospective clinical trial with a total of 96 patients with idiopathic sudden sensorineural hearing loss. Patients were divided into 3 groups. Group 1 n: 32 received systemic steroid treatment. Group 2 n: 32 received the Group 1 protocol plus intratympanic steroid treatment. Group 3 n: 32 received the Group 1 protocol plus hyperbaric oxygen treatment. Pretreatment and postinitial audiologic evaluations were performed, and the hearing outcome was analyzed with Furuhashi criteria. All patients, except those who experienced total recovery after initial treatment, were directed to salvage treatment. Audiologic assessment was performed again after salvage treatment and a mean follow-up period of 36.5 months. Results: Each group was homogenous according to demographics, audiologic data, and prognostic factors. There was no statistically significant difference in recovery and success rate within the 3 groups after initial treatment. P: 0.66, P: 0.248, respectively . Successful results were obtained after salvage treatment in only 3 patients 5% . These patients received follow-up treatment at a mean of 36.5 months, but there was no spontaneous recovery after the end of salvage treatment. Conclusion: The addition of intratympanic steroids or hyperbaric oxygen to systemic steroids caused no significant hearing improvement as the initial treatment of idiopathic sudden sensorineural hearing loss. The efficacy of salvage treatment was limited, and there was no spontaneous hearing improvement after the long-term follow-up.

Keywords:

Idiopathic sudden sensorineural hearing loss, systemic steroid treatment, hyperbaric oxygen therapy, intratympanic steroid treatment, salvage treatment,

PDF

___

1. Kleyn, AD. Sudden complete or partial loss of function of the octavus-system in apparently normal persons. Acta OtoLaryngologica 1994; 32 (5-6): 407-429.
2. O’Connell BP, Hunter JB, Haynes DS. Current concepts in the management of idiopathic sudden sensorineural hearing loss. Current Opinion Otolaryngoly Head Neck Surgery 2016; 24 (5): 413-419. doi: 10.1097/MOO.0000000000000289
3. Seggas I, Koltsidopoulos P, Bibas A, Tzonou A, Sismanis A. Intratympanic steroid therapy for sudden hearing loss: a review of the literature. Otology & Neurotology 2011; 32 (1): 29-35. doi: 10.1097/MAO.0b013e3181f7aba3
4. Chau JK, Lin JR, Atashband S, Irvine RA, Westerberg BD. Systematic review of the evidence for the etiology of adult sudden sensorineural hearing loss. Laryngoscope 2010; 120 (5): 1011-1021. doi: 10.1002/lary.20873
5. Topuz E, Yigit O, Cinar U, Seven H. Should hyperbaric oxygen be added to treatment in idiopathic sudden sensorineural hearing loss?. European Archives of Oto-Rhino-Laryngology and Head & Neck 2004; 261 (7): 393-396. doi: 10.1007/s00405- 003-0688-6
6. Ohno K, Noguchi Y, Kawashima Y, Yagishita K, Kitamura K. Secondary hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss in the subacute and chronic phases. Journal of Medical and Dental Sciences 2010; 57 (2): 127-132. doi: 10.11480/jmds.570201
7. Muzzi E, Zennaro B, Visentin R, Soldano F, Sacilotto C. Hyperbaric oxygen therapy as salvage treatment for sudden sensorineural hearing loss: review of rationale and preliminary report. Journal of Laryngology & Otology 2010; 124 (2): e2. doi: 10.1017/S0022215109992052
8. Lee JB, Choi SJ. Potential benefits of combination therapy as primary treatment for sudden sensorineural hearing loss. Otolaryngology–Head and Neck Surgery 2016; 154 (2): 328-334. doi: 10.1177/0194599815615121
9. Yang HC, Cho YB, Jang CH, Cho HH. Efficacy of concomitant intratympanic steroid injection for sudden deafness according to initial hearing loss. Otology & Neurotology 2015; 36 (10): 1604-1609. doi: 10.1097/MAO.0000000000000869
10. Capuano L, Cavaliere M, Parente G, Damiano A, Pezzuti G et al. Hyperbaric oxygen for idiopathic sudden hearing loss: is the routine application helpful? Acta-Oto-aryngologica, 2015; 135 (7): 692-697. doi: 10.3109/00016489.2015.1023355
11. Lim HJ, Kim YT, Choi SJ, Lee JB, Park HY et al. Efficacy of 3 different steroid treatments for sudden sensorineural hearing loss: a prospective, randomized trial. Otolaryngology- -Head and Neck Surgery 2013; 148 (1): 121-127. doi: 10.1177/019459981246447512. Gao Y, Liu D. Combined intratympanic and systemic use of steroids for idiopathic sudden sensorineural hearing loss: a meta-analysis. European Archives of Oto-Rhino-Laryngology 2016; 273 (11): 3699- 3711. doi: 10.1007/s00405-016-4041-2
13. Rhee TM, Hwang D, Lee JS, Park J, Lee JM. Addition of hyperbaric oxygen therapy vs medical therapy alone for idiopathic sudden sensorineural hearing loss: a systematic review and metaanalysis. JAMA Otolaryngology–Head and Neck Surgery 2018; 144 (12): 1153-1161. doi: 10.1001/jamaoto.2018.2133
14. Eryigit B, Ziylan F, Yaz F, Thomeer HG. The effectiveness of hyperbaric oxygen in patients with idiopathic sudden sensorineural hearing loss: a systematic review. European Archives of Oto-Rhino-Laryngology 2018; 275 (12): 2893- 2904. doi: 10.1007/s00405-018-5162-6
15. Suzuki H, Hashida K, Nguyen KH, Hohchi N, Katoh A et al. Efficacy of intratympanic steroid administration on idiopathic sudden sensorineural hearing loss in comparison with hyperbaric oxygen therapy. Laryngoscope 2012; 122 (5): 1154- 1157. doi: 10.1002/lary.23245
16. Toroslu T, Erdoğan H, Çağlar Ö, Güçlü O, Dereköy FS. Comparison of different treatment methods for idiopathic sudden sensorineural hearing loss. Turkish Archives of Otorhinolaryngology 2018; 56 (4): 226. doi: 10.5152/ tao.2017.2337
17. Furuhashi A, Matsuda K, Asahi K, Nakashima T. Sudden deafness: long-term follow-up and recurrence. Clinical Otolaryngology & Allied Sciences 2002; 27 (6): 458-463. doi: 10.1046/j.1365-2273.2002.00612.x
18. El Sabbagh NG, Sewitch MJ, Bezdjian A, Daniel SJ. Intratympanic dexamethasone in sudden sensorineural hearing loss: A systematic review and meta-analysis. Laryngoscope 2017; 127 (8): 1897-1908. doi: 10.1002/ lary.26394
19. Xenellis J, Karapatsas I, Papadimitriou N, Nikolopoulos T, Maragoudakis P et al. Idiopathic sudden sensorineural hearing loss: prognostic factors. Journal of Laryngology & Otology 2006; 120 (9): 718-724. doi: 10.1017/S0022215106002362
20. Dispenza F, De Stefano A, Costantino C, Marchese D, Riggio F. Sudden sensorineural hearing loss: results of intratympanic steroids as salvage treatment. American Journal of Otolaryngology 2013; 34 (4): 296-300. doi: 10.1016/j. amjoto.2012.12.010
21. Chau JK, Lin JR, Atashband S, Irvine RA, Westerberg BD. Systematic review of the evidence for the etiology of adult sudden sensorineural hearing loss. The Laryngoscope 2010; 120 (5): 1011-1021. doi: 10.1002/lary.20873
22. Labatut T, Daza MJ, Alonso A. Intratympanic steroids as primary initial treatment of idiopathic sudden sensorineural hearing loss. European Archives of Oto-Rhino-Laryngology 2013; 270 (11): 2823-2832. doi: 10.1007/s00405-012-2306-y
23. Cinamon U, Bendet E, Kronenberg J. Steroids, carbogen or placebo for sudden hearing loss: a prospective double-blind study. European Archives of Oto-Rhino-Laryngology 2001; 258 (9): 477-480. doi: 10.1007/s004050100366
24. Wilson WR, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss: a double-blind clinical study. Archives of Otolaryngology 1980; 106 (12): 772- 776.
25. Battaglia A, Burchette R, Cueva R. Combination therapy (intratympanic dexamethasone + high-dose prednisone taper) for the treatment of idiopathic sudden sensorineural hearing loss. Otology & Neurotology 2008; 29 (4): 453-460. doi: 10.1097/MAO.0b013e318168da7a
26. Choung YH, Park K, Shin YR, Cho MJ. Intratympanic dexamethasone injection for refractory sudden sensorineural hearing loss. The Laryngoscope 2006; 116 (5): 747-752. doi: 10.1097/01.mlg.0000205183.29986.f6
27. Xenellis J, Papadimitriou N, Nikolopoulos T, Maragoudakis P, Segas J et al. Intratympanic steroid treatment in idiopathic sudden sensorineural hearing loss: a control study. Otolaryngology—Head and Neck Surgery 2006; 134 (6): 940-945. doi: 10.1016/j.otohns.2005.03.081
28. El Sabbagh NG, Sewitch MJ, Bezdjian A, Daniel SJ. Intratympanic dexamethasone in sudden sensorineural hearing loss: A systematic review and meta-analysis. Laryngoscope 2017; 127 (8): 1897-1908. doi: 10.1002/ lary.26394
29. Gundogan O, Pinar E, Imre A, Ozturkcan S, Cokmez O et al. Therapeutic efficacy of the combination of intratympanic methylprednisolone and oral steroid for idiopathic sudden deafness. Otolaryngology–Head and Neck Surgery 2013; 149 (5): 753-758. doi: 10.1177/0194599813500754
30. Baysal E, Tunç O, Baglam T, Durucu C, Oz A et al. Systemic steroid versus combined systemic and intratympanic steroid treatment for sudden sensorineural hearing loss. Journal of Craniofacial Surgery 2013; 24 (2): 432-434. doi: 10.1097/ SCS.0b013e31828014e7
31. Koltsidopoulos P, Bibas A, Sismanis A, Tzonou A, Seggas I. Intratympanic and systemic steroids for sudden hearing loss. Otology & Neurotology 2013; 34 (4): 771-776. doi: 10.1097/MAO.0b013e31828bb567
32. Cekin E, Cincik H, Ulubil SA, Gungor A. Effectiveness of hyperbaric oxygen therapy in management of sudden hearing loss. Journal of Laryngology & Otology 2009; 123 (6): 609-612. doi: 10.1017/S0022215109004277
33. Alimoglu Y, Inci E, Edizer DT, Ozdilek A, Aslan M. Efficacy comparison of oral steroid, intratympanic steroid, hyperbaric oxygen and oral steroid+ hyperbaric oxygen treatments in idiopathic sudden sensorineural hearing loss cases. European Archives of Oto-Rhino-Laryngology 2011; 268 (12): 1735- 1741. doi: 10.1007/s00405-011-1563-5
34. Fujimura T, Suzuki H, Shiomori T, Udaka T, Mori T. Hyperbaric oxygen and steroid therapy for idiopathic sudden sensorineural hearing loss. European Archives of Oto-RhinoLaryngology 2007; 264 (8): 861-866. doi: 10.1007/s00405-007- 0272-6
35. Filipo R, Attanasio G, Russo FY, Viccaro M, Mancini P et al. Intratympanic steroid therapy in moderate sudden hearing loss: A randomized, triple-blind, placebo-controlled trial. Laryngoscope 2013; 123 (3): 774-778. doi: 10.1002/lary.23678
36. O’Malley MR, Haynes DS. Sudden hearing loss. Otolaryngologic Clinics of North America 2008; 41 (3): 633- 649.37. Yeo SW, Lee DH, Jun BC, Park SY, Park YS. Hearing outcome of sudden sensorineural hearing loss: long-term follow-up. Otolaryngology—Head and Neck Surgery, 2007; 136 (2): 221-224. doi: 10.1016/j.otohns.2006.10.021