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Hearing results of intratympanic steroid treatment of endolymphatic hydrops

Hearing results of intratympanic steroid treatment of endolymphatic hydrops Objectives/Hypothesis: This study evaluated the effectiveness of a single application of steroids to the open middle ear in improving short‐term hearing in patients with Meniere's disease and cochlear hydrops. Study Design: Retrospective study in which each patient's pretreatment hearing served as the control compared with posttreatment hearing. Methods: Patients were treated with a single application of dexamethasone, 8 mg, in hyaluronan. Following tympanotomy and lysis of round window adhesions, steroids were placed in the round window niche with absorbable gelatin sponge and the remainder of the middle ear was then filled with the steroid solution. Systemic steroids were not administered. Audiograms were performed within 1 month before surgery and at least 1 month after surgery. Results: Between September 1996 and July 1997, 21 ears in 19 patients underwent intratympanic steroid treatment. The criterion for hearing change was a 10‐dB or greater change in pure‐tone average (PTA), or a 15% change in speech discrimination score (SDS). Of the 15 ears meeting inclusion criteria for this study, five (33%) demonstrated hearing improvement and three (20%) demonstrated hearing deterioration. Maximum improvement was a 38‐dB improvement in PTA and a 32% improvement in SDS. Conclusion: A single application of intratympanic dexamethasone/hyaluronan solution directly to the round window did not produce dramatic short‐term hearing improvement in patients with endolymphatic hydrops. Although the theoretical basis for intratympanic steroid treatment of endolymphatic hydrops is appealing, we urge close evaluation of the results of specific protocols of intratympanic steroid administration before widespread utilization of this treatment. The choice of steroid, route of administration, frequency of application, and need for simultaneous systemic administration require standardization to adequately assess the efficacy of this treatment. Laryngoscope, 108:1682–1685, 1998 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Laryngoscope Wiley

Hearing results of intratympanic steroid treatment of endolymphatic hydrops

Arriaga, Moisés A.; Goldman, Steve
The Laryngoscope , Volume 108 (11) – Jan 1, 1998
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References (16)

Publisher
Wiley
Copyright
Copyright © 1998 Wiley Subscription Services
ISSN
0023-852X
eISSN
1531-4995
DOI
10.1097/00005537-199811000-00017
Publisher site
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Abstract

Objectives/Hypothesis: This study evaluated the effectiveness of a single application of steroids to the open middle ear in improving short‐term hearing in patients with Meniere's disease and cochlear hydrops. Study Design: Retrospective study in which each patient's pretreatment hearing served as the control compared with posttreatment hearing. Methods: Patients were treated with a single application of dexamethasone, 8 mg, in hyaluronan. Following tympanotomy and lysis of round window adhesions, steroids were placed in the round window niche with absorbable gelatin sponge and the remainder of the middle ear was then filled with the steroid solution. Systemic steroids were not administered. Audiograms were performed within 1 month before surgery and at least 1 month after surgery. Results: Between September 1996 and July 1997, 21 ears in 19 patients underwent intratympanic steroid treatment. The criterion for hearing change was a 10‐dB or greater change in pure‐tone average (PTA), or a 15% change in speech discrimination score (SDS). Of the 15 ears meeting inclusion criteria for this study, five (33%) demonstrated hearing improvement and three (20%) demonstrated hearing deterioration. Maximum improvement was a 38‐dB improvement in PTA and a 32% improvement in SDS. Conclusion: A single application of intratympanic dexamethasone/hyaluronan solution directly to the round window did not produce dramatic short‐term hearing improvement in patients with endolymphatic hydrops. Although the theoretical basis for intratympanic steroid treatment of endolymphatic hydrops is appealing, we urge close evaluation of the results of specific protocols of intratympanic steroid administration before widespread utilization of this treatment. The choice of steroid, route of administration, frequency of application, and need for simultaneous systemic administration require standardization to adequately assess the efficacy of this treatment. Laryngoscope, 108:1682–1685, 1998

Journal

The Laryngoscope – Wiley

Published: Jan 1, 1998

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