Results In the oral prednisone group, PTA improved by dB compared with a -dB improvement in the intratympanic treatment group. Mean pure tone average at 2 months was for the oral steroid treatment group and dB for the intratympanic treatment group. Recovery of hearing on oral treatment at 2 months by intention-to-treat analysis was dB greater than intratympanic treatment (% upper confidence interval, dB). Per-protocol analysis confirmed the intention-to-treat result. Thus, the hypothesis of inferiority of intratympanic methylprednisolone to oral prednisone for primary treatment of sudden sensorineural hearing loss was rejected.
Rauch D. Steven, MD; Halpin F. Christopher, PHD; Antonelli J. Patrick, MD; Babu Seilesh, MD; Carey P. John, MD; Gantz J. Bruce, MD; Goebel J. Joel, MD; Hammerschlag E. Paul, MD; Harris P. Jeffrey, MD, PHD; Isaacson Brandon, MD; Lee Daniel, MD; Linstrom J. Christopher; Parnes S. Lorne, MD; Shi Helen, MS; Slattery H. William, MD; Telian A. Steven, MD; Vrabec T. Jeffrey, MD; Reda J. Domenic, PHD “Oral vs Intratympanic Corticosteroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss” The Journal of the American Medical Association (.) Taken from:
http://-/content/305/20/?sid=85677bf8-88a4-... Taken on October 10, 2011
The injections are performed with the patient lying down and using the office microscope. The ear is first cleaned of wax. A small area of the eardrum is numbed with a drop of medication. A small needle and syringe are then used and the needle is passed through the eardrum at the site that is numbed so that the tip is in the ear, near the round window. This is a membrane where drugs are absorbed in to the cochlea. The fluid is injected in to the middle ear and the patient stays lying down for 20-30 minutes during which he does not swallow or sniff. The drug sits against the round window and is absorbed in to the inner ear. The patient then sits up slowly and leaves the office. Patients should not drive for a few hours after this procedure. Water is kept out of the ear until it is confirmed that the tiny hole has healed.