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Information Journal Paper

Title

COMBINATION OF INTRATYMPANIC DEXAMETHASONE AND SYSTEMIC PREDNISOLONE IN THE TREATMENT OF POOR PROGNOSIS SUDDEN SENSORINEURAL HEARING LOSS (SSNHL)

Writers

TAJADINI A.

Pages

 Start Page 47 | End Page 47

Keywords

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Abstract

 Objective: To investigate the efficacy of adding intratympanic dexamethasone to systemic prednisolone in the treatment of sudden sensorineural hearing loss (SSNHL) patients with poor prognosis Design: Prospective clinical trial study.Methods: Patients with SSNHL who met one of these criteria were included in the study: 1. Patients with severe or profound hearing loss, 2. Patients older than 40 years of age, and 3. The interval between the onsets of sudden deafness and the initiation of therapy was more than two weeks. They were randomly divided into two groups on the basis of therapy. One group received systemic prednisolone (1mg/kg/day for 10 days) and acyclovir (2 gr/day for 10 days) and the other received systemic prednisolone and acyclovir and intratympanic dexamethasone (0.4 ml of 4mg/ml dexamethasone). Intratympanic injections were performed in the supine position; twice a week, for two weeks (an overall of four injections). Hearing evaluation was performed two weeks after the treatment. The response to therapy was defined as improvement of more than 15 dB in PTA or 20% improvement in SDS. Results: Seventy-seven patients fit the criteria for inclusion in the study. Forty-four patients (57.14%) showed an improvement in the hearing evaluation (35.06% in the intratympanic dexamethasone and systemic prednisolone group, and 22.08% in the other group). A statistically significant difference was noted in the patients who received a combination of IT injection and systemic prednisolone (p value:0.001). Conclusion: Combination of intratympanic dexamethasone and systemic prednisolone is more effective than systemic prednisolone in the treatment of poor prognosis sudden sensorineural hearing loss.

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