Steroid perfusion of the inner ear via the MicroWickTM appears to improve hearing in some patients with SSNHL. A low concentration of dexamethasone (4 mg/cc) produces better hearing results with less chance of complications, especially when the patient is treated within a four-week period. Those who initially respond to oral steroids have a higher likelihood of responding to steroid perfusion of the inner ear. Overall, the treatment is recommended when oral steroids are not practical due to other health reasons, the patient refuses oral steroids, the patient has a partial response to oral steroids, and possibly in cases when oral steroids fail the patient.
Methods: Forty adults with unilateral sudden sensorineural hearing loss (defined as a loss of at least 30 dB in 3 contiguous frequencies within 72 hours) and no clinically identifiable etiology were included in this retrospective review. Patients were treated with either oral steroids alone, oral steroids in combination with transtympanic steroid therapy, and transtympanic steroids alone. Treatment with transtympanic steroids alone was restricted to patients with medical contraindications for systemic steroid therapy. In the majority of patients, transtympanic steroids were administered as a single injection of dexamethasone at the time of initial evaluation. Patients in the other 2 treatment groups were self-selected. Pre- and posttreatment audiometric results were compared.