Analysis of factors influencing the effective dose of intratympanic steroid injection of dexamethasone in idiopathic sudden sensorineural hearing loss.
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| Title: | Analysis of factors influencing the effective dose of intratympanic steroid injection of dexamethasone in idiopathic sudden sensorineural hearing loss. |
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| Authors: | Zhu, Zhengjie (AUTHOR), Chen, Jianyong (AUTHOR), Li, Shuna (AUTHOR), Yang, Jun (AUTHOR), Wei, Wei (AUTHOR) |
| Source: | Acta Oto-Laryngologica. Sep2025, Vol. 145 Issue 9, p811-819. 9p. |
| Subjects: | Steroids, Auditory perception testing, Research funding, Sensorineural hearing loss, Tympanic membrane, Eustachian tube, Treatment effectiveness, Descriptive statistics, Injections, Dose-effect relationship in pharmacology, Drug efficacy, Sudden onset of disease, Dexamethasone |
| Abstract (English): | Background: Currently, Intratympanic steroid injection (ITSI) has been identified as a common method for delivering dexamethasone to the inner ear in idiopathic sudden sensorineural hearing loss (ISSNHL). Objective: This study analyzed factors influencing dexamethasone effective dose in ITSI, aiming to optimize injection protocols and efficacy assessment. Materials and methods: A total of 251 ISSNHL patients received ITSI with 5 mg dexamethasone, and drug leakage from the external auditory canal was quantified. The effects of Eustachian tube function (assessed via taste method), injection speed (5 vs. 10 s), and injection site (anteroinferior, posteroinferior, anterosuperior tympanic membrane) on the effective dose were evaluated. The pretreatment and posttreatment audiological examination results were collected, and the relationship between the effective dosage and the efficacy was analyzed. Results: Significantly higher median leakage (1.90 mg vs. 0.75 mg, p < 0.01) was showed in patients with bitter taste, indicating passive eustachian tube opening. However, injection speed and site had no significant impact on leakage (p > 0.05). No significant differences in hearing outcomes were observed between high (>3.5 mg) and low (≤3.5 mg) effective dose groups (p > 0.05). Conclusions and significance: ITSI effective dose primarily depends on eustachian tube function, and low-dose dexamethasone (sufficient to fill the tympanic cavity) is equally efficacious, suggesting simplified clinical protocols. [ABSTRACT FROM AUTHOR] |
| Abstract (Chinese): | 目前, 鼓室注射类固醇(ITSI)已被确认为地塞米松内耳给药来治疗特发性突发性神经性听力损失(ISSNHL)的常用方法。 本研究分析了影响ITSI过程中地塞米松有效剂量的因素, 旨在优化注射方案和评估疗效。 251例ISSNHL患者接受了ITSI, 被注射5mg地塞米松, 并量化外耳道药物渗漏情况。评估了咽鼓管功能(通过味觉评估)、注射速度(5秒 vs. 10秒)和注射部位(鼓膜前下、后下、前上)对有效剂量的影响。收集治疗前后听力学检查结果, 并分析有效剂量与疗效之间的关系。 味觉较苦的患者中位漏出量显著较高(1.90mg vs. 0.75mg, p < 0.01), 提示咽鼓管被动开放。然而, 注射速度和注射部位对漏出量无显著影响(p > 0.05)。高有效剂量组(>3.5mg)和低有效剂量组(≤3.5mg)之间的听力结果无显著差异(p > 0.05)。 ITSI有效剂量主要取决于咽鼓管功能, 而且低剂量地塞米松(足以填充鼓室)同样有效。因此, 建议简化临床方案。 [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Background: Currently, Intratympanic steroid injection (ITSI) has been identified as a common method for delivering dexamethasone to the inner ear in idiopathic sudden sensorineural hearing loss (ISSNHL). Objective: This study analyzed factors influencing dexamethasone effective dose in ITSI, aiming to optimize injection protocols and efficacy assessment. Materials and methods: A total of 251 ISSNHL patients received ITSI with 5 mg dexamethasone, and drug leakage from the external auditory canal was quantified. The effects of Eustachian tube function (assessed via taste method), injection speed (5 vs. 10 s), and injection site (anteroinferior, posteroinferior, anterosuperior tympanic membrane) on the effective dose were evaluated. The pretreatment and posttreatment audiological examination results were collected, and the relationship between the effective dosage and the efficacy was analyzed. Results: Significantly higher median leakage (1.90 mg vs. 0.75 mg, p < 0.01) was showed in patients with bitter taste, indicating passive eustachian tube opening. However, injection speed and site had no significant impact on leakage (p > 0.05). No significant differences in hearing outcomes were observed between high (>3.5 mg) and low (≤3.5 mg) effective dose groups (p > 0.05). Conclusions and significance: ITSI effective dose primarily depends on eustachian tube function, and low-dose dexamethasone (sufficient to fill the tympanic cavity) is equally efficacious, suggesting simplified clinical protocols. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 00016489 |
| DOI: | 10.1080/00016489.2025.2521809 |
