Intratympanic Steroids for Inner Ear Disorders: A Review

@article{Hu2009IntratympanicSF,
  title={Intratympanic Steroids for Inner Ear Disorders: A Review},
  author={Amanda Hu and Lorne S. Parnes},
  journal={Audiology and Neurotology},
  year={2009},
  volume={14},
  pages={373 - 382}
}
Background/Aim: The use of intratympanic steroids (ITS) has proliferated over the past 10–15 years to include treatments for inner ear disorders, like Ménière’s Disease (MD) and sudden sensorineural hearing loss (SSNHL). The aim of this study was to review the clinical trials of ITS for inner ear disorders. Methods: PubMed and Ovid Medline databases were searched from 1966 to present for clinical trials on ITS in the treatment of MD and SSNHL. Studies were evaluated based on comparability and… 

Tables from this paper

Intratympanic Steroid Treatment for Sudden Deafness: A Meta-analysis of Randomized Controlled Trials
  • W. Garavello, F. Galluzzi, R. Gaini, D. Zanetti
  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2012
TLDR
Intratympanic steroid therapy seems to confer a certain degree of benefit as a salvage but not as a primary treatment of SD, however, further evidence is needed to clarify some yet uncertain aspects, such as the optimal protocol of therapy.
Intratympanic steroids for Ménière's disease or syndrome.
TLDR
The results of a single trial provide limited evidence to support the effectiveness of intratympanic steroids in patients with Ménière's disease, and a statistically and clinically significant improvement of the frequency and severity of vertigo measured 24 months after the treatment was administered.
Intratympanic Glucocorticoids for Sudden Sensorineural Hearing Loss: A Systematic Review #
TLDR
Compared with the control group, intratympanic glucocorticoids can significantly increase the hearing recovery rate of patients, and multi-center, large-scale, double-blinded randomized control trials are needed to confirm the available evidence.
Intratympanic Dexamethasone in the Treatment of Ménière's Disease: A Comparison of Two Techniques.
  • J. Beyea, R. Instrum, S. Agrawal, L. Parnes
  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2017
TLDR
Intratympanic dexamethasone injections were successful in controlling vertigo insofar as they were able to obviate ablative therapy in the majority of Ménière's disease patients in this study, suggesting that IT Dex may be a nonablative option for patients with bilateral disease or only hearing/vestibular ears.
[Intratympanic steroid administration: use in the treatment of profound idiopathic sudden sensorineural hearing loss].
TLDR
Combination therapy with intratympanic steroids showed a tendency for better hearing results without serious side effects, however, because current evidence is not adequate, randomized placebo-controlled multicenter studies are needed.
Intratympanic dexamethasone injections for refractory Meniere' s disease.
TLDR
The results demonstrate that intratympanic dexamethasone injection, as an effective therapeutic strategy for refractory Meniere's disease, could either be used for cascade therapy preoperation or used for patients who couldn't accept the surgery.
Randomized Controlled Trial Intratympanic Treatment of Intractable Unilateral Ménière Disease : Gentamicin or Dexamethasone ? A
TLDR
Low-dose ITG achieved better outcome than ITD in the control of vertigo attacks in patients suffering from unilateral MD, with a very low incidence of hearing deterioration.
Intratympanic Treatment of Intractable Unilateral Ménière Disease
TLDR
Low-dose ITG achieved better outcome than ITD in the control of vertigo attacks in patients suffering from unilateral MD, with a very low incidence of hearing deterioration.
Therapeutic Effect of Intratympanic Injection of Dexamethasone plus Hyaluronic Acid on Patients with Meniere's disease
TLDR
Intratympanic dexamethasone/hyaluronic acid had a positive effect on the vertigo of the investigated patients without any significant improvement in hearing impairment and tinnitus in the short term.
...
...

References

SHOWING 1-10 OF 64 REFERENCES
Intratympanic steroid therapy for inner ear diseases, a review of the literature
TLDR
Reliable evidence on the efficiency, optimum dosage and administration schedule of intratympanic steroid therapy in MD, ISSNHL and RPSNHL is lacking, therefore further investigation is required.
Issues, indications, and controversies regarding intratympanic steroid perfusion
  • M. Hamid, D. Trune
  • Medicine, Biology
    Current opinion in otolaryngology & head and neck surgery
  • 2008
TLDR
A sound understanding of the basic science and clinical studies is needed to establish long-term efficacy of ITPs in controlling hearing loss in Ménière's disease by comparison to its natural history, as well as, potential application to other disorders.
Intratympanic steroids: Do they acutely improve hearing in cases of cochlear hydrops?
TLDR
Intratympanic administration of dexamethasone may acutely affect sensorineural hearing loss associated with endolymphatic hydrops in patients with cochlear hydrops.
Intratympanic Steroid Treatment in Idiopathic Sudden Sensorineural Hearing Loss: A Control Study
Treatment of sudden sensorineural hearing loss: I. A systematic review.
TLDR
No valid RCT exists to determine effective treatment of sudden sensorineural hearing loss, and systemic steroids cannot be considered the gold standard of treatment of SSHL, given the severe limitations of the landmark study supporting their use.
Intratympanic Steroid Treatment of Inner Ear Disease and Tinnitus (Preliminary Report)
TLDR
This preliminary study has shown that intratympanic steroids may affect the symptoms of hearing loss and tinnitus in patients with various inner ear problems.
Hearing results of intratympanic steroid treatment of endolymphatic hydrops
TLDR
A single application of intratympanic dexamethasone/hyaluronan solution directly to the round window did not produce dramatic short‐term hearing improvement in patients with endolymphatic hydrops, and it is suggested that standardization is needed to adequately assess the efficacy of this treatment.
Dexamethasone inner ear perfusion for the treatment of Meniere's disease: a prospective, randomized, double-blind, crossover trial.
TLDR
Intratympanic administration of dexamethasone in a group of patients with unilateral Meniere's disease (Shea's stage IV) showed no benefit over placebo for the treatment of hearing loss and tinnitus.
Intratympanic Corticosteroids for Sudden Idiopathic Sensorineural Hearing Loss
  • A. Banerjee, L. Parnes
  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2005
TLDR
Instillation of intratympanic steroids represents a safe and potentially effective treatment of sudden idiopathic sensorineural hearing loss and those treated within 10 days of onset had a statistically significant better outcome.
Treatment of vestibular disorders.
TLDR
In cases of Menière's disease that are resistant to drug therapy, these two therapeutic methods appear to be worthwhile before attempting surgical treatment for refractory vertigo.
...
...