StatPearls-/-ä 2024[Jan]; ä (ä): ä PMID33620785show ga
Steroid treatment is routinely given for patients with inner ear disorders, such as unremitting Meniere's disease or idiopathic sudden sensorineural hearing loss (ISSNHL). However, for some patients, systemic steroids may be unsuccessful or contraindicated; therefore, intratympanic steroid (ITS) administration may be a suitable alternative for rapid symptom control. ITS is increasingly used as a treatment for inner ear disease. It is generally well-tolerated, has been shown to result in superior perilymph concentration of steroids without the risk of systemic side effects, and so can be used as an alternative or in addition to systemic steroid use. Idiopathic sudden sensorineural hearing loss (ISSNHL), considered an otological emergency, is defined as deafness of cochlear or retrocochlear origin within 72 hours, affecting at least 3 consecutive frequencies by 30 dB or greater with no identifiable cause. Global incidence has been estimated to be 5 to 20 per 100,000 persons per year. In the UK, the National Institute for Health and Care Excellence (NICE) recommend steroids as first-line treatment for ISSNHL. This can comprise oral steroids, intratympanic steroid injections (ITSI), or a combination of both. Guidelines from the American Academy of Otolaryngology-Head and Neck in 2019 advise that clinicians offer patients intratympanic steroid salvage therapy where there is incomplete recovery from sudden sensorineural hearing loss (SSHL) 2 to 6 weeks after onset of symptoms. Meniere's disease causes unstable or fluctuating sensorineural hearing levels and vestibular function due to the inner ear mechanisms' failure. The International Consensus (ICON) on treating Meniere disease recommends ITS as second-line therapy when medical treatment has failed.
StatPearls-/-ä 2024 ; ä (ä): ä
