105

DEXAMETHASONE INNER EAR PERFUSION BY INTRATYMPANIC INJECTION VS ORAL PREDNISONE IN UNILATERAL IDIOPHATIC SUDDEN SENSORINEURAL HEARING LOSS: A TWO YEAR PROSPECTIVE, RANDOMIZED TRIAL.

■ OBJECTIVE: To compare hearing outcome between two well known oral corticosteroids treatment regimens vs. dexamethasone inner ear perfusion (DIEP) by intratympanic injection in patients who have unilateral idiophatic sudden sensorineural hearing loss.

■ METHOD: Since april 2003 to april 2007 , patients older than 18 years of age with unilateral idiophatic sudden sensorineural hearing loss installed in a maximun of three days, no more than 10 days of evolution and with 50dB or more or hearing loss in pure tone audiogram (PTA) and 50% or less in speech discrimination score (SDS). Any patient had previous medical treatment with steroids. Informed consent and magnetic resonance imaging were obtained in each patient. We form three groups: Group A: Oral predinose 1mg/kg in one take for 7 days and tapered, Group B: Oral prednisone 1mg/kg in one take for 30 days and tapered and Group C: Dexamethasone inner ear perfusion by intratympanic injection. The injection was made once daily for 5 consecutive days. A change of 10 dB or more in PTA, or 15% or more in SDS was considered clinically significant.

■ RESULTS: Group A (9 patients): 77% (7 patients) have significant improvement of 10dB or more. Group B (6 patients): 66% (4 patients) have significant improvement. Group C (9 patients): 88% (8 patients) have an improvement of 10 dB or more.

■ CONCLUSION: Dexamethasone inner ear perfusion by intratympanic injection has better profile than oral prednisone in patients with unilateral idiophatic sudden sensorineural hearing loss.