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Cited by 54Vestibular and auditory disordersHearing, Cochlea, Tinnitus, GeneticsHearing Loss and Rehabilitation

Hearing changes after intratympanically applied steroids for primary therapy of sudden hearing loss: a meta-analysis using mathematical simulations of drug delivery protocols

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Liebau, Arne, Pogorzelski, Olivia, Salt, Alec N., Plontke, Stefan K.·2017·Otology & Neurotology
DOI 10.1097/mao.0000000000001254PMC PMC5154844
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Abstract

Objective: Controlled and uncontrolled studies with primary intratympanic or combined intratympanic and systemic application of glucocorticosteroids for idiopathic sudden hearing loss were analyzed by means of a meta-analysis in an attempt to establish optimal local drug delivery protocols. Study Design: A total of 25 studies with 28 treatment groups between January 2000 and June 2014 were selected that adequately described drug delivery protocols. Cochlear drug levels were calculated by a validated computer model of drug dispersion in the inner ear fluids based on the concentration and volume of glucocorticoids applied, the time the drug remained in the middle ear, and the specific timing of injections. Various factors were compared with hearing outcome, including baseline data, individual parameters of the application protocols, calculated peak concentration (C max), and total dose (area under the curve). Results: There was no dependence of hearing outcome on individual parameters of the application protocol, C max, or area under the curve. Final hearing threshold was notably independent of delay of treatment. Conclusion: During primary intratympanic or combined steroid therapy of idiopathic sudden hearing loss, the tendency toward early treatment having a positive effect on hearing improvement is thought to be a “sham effect,” likely related to spontaneous recovery. Change in pure-tone average may not be an adequate outcome parameter to assess effectiveness of the intervention, as it depends on the degree of initial hearing loss. Final pure-tone average provides a better alternative.

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  • Worse baseline PTA values predicted poorer recovery.

    “contrary to previous work [13], we found that worse baseline PTA values predicted poorer recovery.”

    From Intratympanic steroid administration and predictors of recovery in sudden sensorineural hearing loss (2025) · cites this paper as [13]

  • The average time from symptom onset to IT treatment in our cohort was two weeks longer than those reported by Liebau et al.

    “The average time from symptom onset to IT treatment in our cohort was two weeks longer than those reported by Liebau et. al.”

    From Intratympanic steroid administration and predictors of recovery in sudden sensorineural hearing loss (2025) · cites this paper as [13]

    The Methods (Data Sources and Study Selection; page unavailable) discuss delay from symptom onset to treatment, and the Results (page unavailable) analyze treatment delay. Neither passage gives an average onset-to-IT-treatment time for Liebau et al.’s study groups, so the claimed two-week difference cannot be checked against our copy. Searched for mean and average onset-to-treatment intervals and the two-week figure. (LLM, conf=0.72)

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Authors
Liebau, A., Pogorzelski, O., Salt, A. N., & Plontke, S. K.
Affiliations
  • Martin Luther University Halle-Wittenberg (DE)
  • Washington University in St. Louis (US)
Corresponding author
  • Liebau, Arne
  • Pogorzelski, Olivia
  • Plontke, Stefan K.
ORCID
Venue
Otology & Neurotology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-01
Volume
38
Issue
1
Pages
19-30
ISSN
  • 1531-7129 (ISSN-L)
  • 1537-4505
DOI
10.1097/mao.0000000000001254
PMC
PMC5154844
OpenAlex
W2535900900
Cited by
54
References
2
Citations by year
2026: 3 · 2025: 7 · 2024: 7 · 2023: 1 · 2022: 7 · 2021: 5 · 2020: 7 · 2019: 6 · 2018: 9 · 2017: 2
FWCI
0.50
Type
journal article
Language
en
Open access
Locations
  • Otology & Neurotology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Deafness and Other Communication Disorders (R01DC001368)
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 steroid injection, glucocorticoids, hearing outcomes, treatment timing, pure-tone average, area under the curve, peak concentration
MeSH terms
Injection, Intratympanic, Computer Simulation, Hearing Loss, Sudden, Glucocorticoids, Hearing, Humans, Middle Aged, Treatment Outcome

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