Complications and prognosis associated with intra-tympanic steroid injection to treat sudden sensorineural hearing impairment

• Published in: American journal of otolaryngology 2022-01, Vol.43 (1), p.103221-103221, Article 103221
• Main Authors: Hu, Chih-Yu, Lien, Kuang-Hsu, Chen, Shih-Lung, Zhang, Bang-Yan, Chan, Kai-Chieh
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Complication; Complications; Diabetes; Ear Diseases - chemically induced; Ear Diseases - epidemiology; Earache - chemically induced; Eardrum; Ears & hearing; Female; Hearing; Hearing - drug effects; Hearing loss; Hearing Loss, Sensorineural - drug therapy; Hearing Loss, Sudden - drug therapy; Hearing recovery; Hepatitis; Humans; Incidence; Injection; Injection, Intratympanic - adverse effects; Intra-tympanic steroid injection; Male; Materials recovery; Medical prognosis; Middle Aged; Pain; Patients; Perforation; Prognosis; Recovery of Function; Retrospective Studies; Steroid hormones; Steroids; Steroids - administration & dosage; Steroids - adverse effects; Sudden sensorineural hearing loss; Systemic diseases; Taste disorders; Tinnitus; Tympanic Membrane Perforation - chemically induced; Vertigo; Vertigo - chemically induced; Young Adult
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2021.103221

The purpose of this study was to measure the incidence of complications in sudden sensorineural hearing loss (SSNHL) patients treated with intra-tympanic steroid injection (ITSI) and compare hearing recovery rates. 123 patients with unilateral SSNHL receiving ITSIs were included in this study. Post-ITSI complications were documented including otalgia, dysgeusia, vertigo (duration>1 h), and persistent eardrum perforation. The pain intensity was evaluated with visual analog scale (VAS). Hearing was measured before ITSI and at 1 month after the final ITSI. We compared our patients' hearing threshold between presence and absence of different complications. 47.2% patients experienced post-injection otalgia with the average VAS score 3.2 (range 2–6). Five (4.1%) and six (4.9%) patients exhibited vertigo and persistent eardrum perforations, respectively. The patients were divided into three groups based on the absence of complications and the presence of vertigo and eardrum perforation. The hearing threshold improvements did not differ significantly among the three groups (p = 0.366). Although the difference was not significant (p = 0.664), the proportion of patients experiencing post-ITSI vertigo who were on contemporaneous oral steroids was lower than the proportion of non-vertigo patients on such steroids. The incidences of otalgia, vertigo, and persistent eardrum perforation in SSNHL patients treated with ITSI were 47.2%, 4.1% and 4.9%, respectively. We found no association between concurrent oral steroid use and the incidence of post-ITSI eardrum perforation or vertigo. Although statistical significance was lacking, patients who did not take contemporaneous oral steroids may have a higher rate of prolonged post-ITSI vertigo.