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Cited by 48Vestibular and auditory disordersHearing, Cochlea, Tinnitus, GeneticsHearing Loss and Rehabilitation

Dose Effect of Intratympanic Dexamethasone for Idiopathic Sudden Sensorineural Hearing Loss: 24 mg/mL Is Superior to 10 mg/mL

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Alexander, Thomas H., Harris, Jeffrey P., Nguyen, Quyen T., Vorasubin, Nopawan·2015·Otology & Neurotology
DOI 10.1097/mao.0000000000000834
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Abstract

OBJECTIVE: To compare outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) treated with intratympanic (IT) dexamethasone (DEX) at either 10 mg/mL or 24 mg/mL. STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. PATIENTS: Thirty-seven adults with ISSNHL. INTERVENTIONS: In addition to concurrent prednisone taper, patients received a series of IT DEX injections for 2 weeks with either 10 mg/mL or 24 mg/mL. MAIN OUTCOME MEASURE: Greater than 30-dB improvement in pure-tone average (PTA). RESULTS: Baseline characteristics were similar between groups. Mean follow-up was 10 weeks. Ten (53%) of 19 patients treated with 24 mg/mL had greater than 30-dB improvement in PTA compared with 3 (17%) of 18 treated with 10 mg/mL (p = 0.0382, Fisher's exact test). There was a trend toward improved word recognition score outcome with 24 mg/mL. The interval between onset and initiation of IT DEX significantly affected outcome, with earlier treatment resulting in greater improvement in PTA and word recognition score. Multivariate logistic regression confirmed that IT DEX dose and interval to starting treatment were both independent predictors of PTA outcome. Change in PTA was not significantly affected by age, sex, pretreatment hearing levels, or concurrent treatment with hyperbaric oxygen. CONCLUSION: To our knowledge, this is the first demonstration of superiority of IT DEX at 24 mg/mL for the treatment of ISSNHL, with significantly better recovery of PTA. Our data suggest that treatment should be initiated as soon as possible. A prospective randomized trial to confirm the optimal dose is warranted.

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  • The finding underscores the critical, time-sensitive nature of early referral and intervention, particularly among nonotolaryngologists.

    “More broadly, this finding underscores the critical, time-sensitive nature of early referral and intervention, particularly among nonotolaryngologists [2,8,9].”

    From Intratympanic steroid administration and predictors of recovery in sudden sensorineural hearing loss (2025) · cites this paper as [8]

    The Discussion (page unavailable) calls idiopathic sudden sensorineural hearing loss an otologic emergency and says early therapy maximizes the chance of recovery; the Conclusion recommends starting treatment as soon as possible. The paper does not address referral practices or nonotolaryngologists specifically. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
Alexander, T. H., Harris, J. P., Nguyen, Q. T., & Vorasubin, N.
Affiliations
  • Veterans Health Administration (US)
  • University of California San Diego (US)
Corresponding author
  • Alexander, Thomas H.
  • Harris, Jeffrey P.
  • Nguyen, Quyen T.
  • Vorasubin, Nopawan
ORCID
Venue
Otology & Neurotology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-09
Volume
36
Issue
8
Pages
1321-1327
ISSN
1531-7129 (ISSN-L)
DOI
10.1097/mao.0000000000000834
OpenAlex
W2404519752
Cited by
48
References
1
Citations by year
2026: 3 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 6 · 2017: 3 · 2016: 5
FWCI
2.49
Type
journal article
Language
en
Open access
Locations
  • Otology & Neurotology (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Topics
  • Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
  • Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
Keywords
idiopathic sudden sensorineural hearing loss, intratympanic dexamethasone, corticosteroid injection, prednisone, pure-tone average, word recognition score, treatment timing, hearing recovery
MeSH terms
Injection, Intratympanic, Anti-Inflammatory Agents, Audiometry, Pure-Tone, Hearing Loss, Sudden, Dexamethasone, Female, Hearing Loss, Sensorineural, Humans, Hyperbaric Oxygenation, Male, Middle Aged, Prednisone, Prospective Studies, Retrospective Studies, Speech Perception, Speech Reception Threshold Test, Tympanic Membrane, Treatment Outcome

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