Korean J Otorhinolaryngol-Head Neck Surg.  2019 Jul;62(7):379-384. 10.3342/kjorl-hns.2018.00892.

Comparison of Intratympanic, Systemic, and Combined Steroid Therapies for Sudden Sensorineural Hearing Loss in Patients with Diabetes Mellitus

• Kim HJ
• Lee YJ
• Kang HT
• Lee SA
• Lee JD
• Kim BG

• KMID: 2453930
• DOI: http://doi.org/10.3342/kjorl-hns.2018.00892

Abstract

BACKGROUND AND OBJECTIVES
We investigated whether the intratympanic steroid injections might be an effective initial treatment for sudden sensorineural hearing loss (SSNHL) in patients with diabetes mellitus (DM).
SUBJECTS AND METHOD
We assessed a total of 167 patients with DM and SSNHL who visited a tertiary referral otolaryngology department between January 2010 and April 2018. Forty-two patients with DM and SSNHL received intratympanic steroid injections; 48 patients with DM and SSNHL received systemic steroid treatment; and 77 patients with DM and SSNHL received a combination of systemic and intratympanic treatment. Initial and post treatment hearing levels and fasting blood sugar (FBS) were assessed, and correlations between hearing gain and the duration of DM, HbA1c, FBS were investigated.
RESULTS
After steroid treatment, hearing levels were 38.87±25.35 dB in the intratympanic injection group, 41.09±28.49 dB in the systemic steroid treatment group, and 47.81±27.12 dB in the combined treatment group. Final hearing levels and hearing gain in the three groups did not differ significantly. FBS after treatment in the systemic steroid treatment and combined steroid treatment group worsened relative to the intratympanic injection group (202.00±9.40 mg/dL to 326.63±7.85 mg/dL). FBS, duration of DM, and HbA1c levels did not affect the hearing gain in patients with DM and SSNHL.
CONCLUSION
Intratympanic steroid injections are comparable to the systemic steroid treatment modality for SSNHL in patients with DM. Thus, intratympanic steroid injections may serve as an effective initial treatment modality for SSNHL in patients with DM.

Keyword

Diabetes mellitus; Steroids; Sudden sensorineural hearing loss

MeSH Terms

Blood Glucose
Diabetes Mellitus*
Fasting
Hearing
Hearing Loss, Sensorineural*
Humans
Injection, Intratympanic
Methods
Otolaryngology
Referral and Consultation
Steroids
Blood Glucose
Steroids