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

Am J Otolaryngol. 2022 Jan-Feb;43(1):103221. doi: 10.1016/j.amjoto.2021.103221. Epub 2021 Sep 10.

Abstract

Purpose: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Complication; Hearing recovery; Intra-tympanic steroid injection; Sudden sensorineural hearing loss.

Publication types

  • Clinical Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ear Diseases / chemically induced
  • Ear Diseases / epidemiology*
  • Earache / chemically induced
  • Female
  • Hearing / drug effects
  • Hearing Loss, Sensorineural / drug therapy*
  • Hearing Loss, Sudden / drug therapy*
  • Humans
  • Incidence
  • Injection, Intratympanic / adverse effects*
  • Male
  • Middle Aged
  • Prognosis
  • Recovery of Function
  • Retrospective Studies
  • Steroids / administration & dosage*
  • Steroids / adverse effects*
  • Tympanic Membrane Perforation / chemically induced
  • Vertigo / chemically induced
  • Young Adult

Substances

  • Steroids