Faculty Collaboration Database

Standardization of Outcome Measures for Intratympanic Steroid Treatment for Idiopathic Sudden Sensorineural Hearing Loss. Otol Neurotol 2022 Dec 01;43(10):1137-1143

Date

10/04/2022

Pubmed ID

36190905

DOI

10.1097/MAO.0000000000003709

Scopus ID

2-s2.0-85141892655 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

OBJECTIVE: To identify variability in reported hearing outcomes for intratympanic (IT) steroid treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) by comparing outcomes using the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guideline with other published criteria.

STUDY DESIGN: Retrospective chart review.

SETTING: Tertiary otology practice.

PATIENTS: Patients with ISSNHL treated with IT steroid between April 2003 and December 2020.

INTERVENTIONS: IT steroid injection and audiometric evaluation.

MAIN OUTCOME MEASURES: 1) Rates of full, partial, or no recovery using the AAO-HNS guideline versus other reported criteria, and 2) correlation analyses of demographic and clinical variables with response to IT steroid.

RESULTS: Using AAO-HNS reporting criteria, full recovery of the pure-tone average was noted in 25.68% of patients. Applying eight other published outcomes criteria to this patient cohort classified full recovery in 14.87 to 40.54% of patients. Similarly, AAO-HNS criteria classified "no recovery" in 51.35% of our patients, whereas applying the other reported criteria showed an average rate of 62.16% no recovery and as high as 82.43% of patients without recovery. Younger age ( p = 0.003; effect size, 0.924) and IT injection within a week of onset ( p < 0.001; effect size, 1.099) positively correlated with full recovery. There was no impact of prior or concurrent oral steroids, or number of steroid injections on outcome.

CONCLUSION: Great variability exists in the literature for assessment of IT steroid outcomes in ISSNHL. Standard reporting of outcomes as per the AAO-HNS SSNHL guideline is recommended to consistently characterize IT steroid efficacy and allow comparison across studies.

Author List

Osafo NK, Friedland DR, Harris MS, Adams J, Davis C, Osinski K, Tong L, Luo J

Authors

David R. Friedland MD Associate Director, Director, Chief, Professor in the Otolaryngology department at Medical College of Wisconsin
Michael S. Harris MD Associate Professor in the Otolaryngology department at Medical College of Wisconsin
Jake Luo Ph.D. Associate Professor; Director, Center for Biomedical Data and Language Processing (BioDLP) in the Health Informatics & Administration department at University of Wisconsin - Milwaukee

MESH terms used to index this publication - Major topics in bold

Audiometry, Pure-Tone
Dexamethasone
Glucocorticoids
Hearing Loss, Sensorineural
Hearing Loss, Sudden
Humans
Injection, Intratympanic
Reference Standards
Retrospective Studies
Steroids
Treatment Outcome