Experience with Local Therapy of Sudden Hearing Defects of Cochlear Origin


Authors: K. Malinová 1;  D. Janeček 2;  L. Lavička 2,3
Authors‘ workplace: Klinika dětské ORL LF MU a FN v Brně 1;  ENT – Med., s. r. o. 2
Published in: Otorinolaryng. a Foniat. /Prague/, 62, 2013, No. 1, pp. 14-18.
Category: Original Papers

Overview

Local corticoid therapy appears to be a contributing therapy in the therapy of ear diseases. We presently offer the patients a local corticoid therapy in cases of sudden hearing disorders as well as to those with disorder of Eustachian tube function. The method we apply is based on introduction of tympanostomic tube with a “candlewick” – the Microwick and administration of corticoids in the form of drops into external auditory meatus for the period of several weeks.

The sudden sensory-neural is defined as hearing deterioration at 3 adjacent frequencies by 30dB in tone audiometry, which last more than 3 days. Standard present therapy of sudden sensory-neural hearing disorder of cochlear type is commonly executed by a combinatoion of several kinds of treatment (hyperbaric oxygen therapy, vasodilatation therapy, systemic administration of corticosteroids and local administration of corticosteroids.

At the KDORL Clinic, Faculty Hospital at Brno and Medical Faculty at Brno we have applied therapy of sudden hearing disorders by administration of corticoids in the form of drops via a introduction of Microwick tympanostomy tube (with introduced porour “candlewick” through the tube lumen) directly into the area of oval window. The procedure was approved by Ethical Committee of Faculty Hospital at Brno.

In patients of the evaluated group with a sudden hearing disorder the improvement of hearing was reached in seven evaluated ears out of the 11 evaluated (81.8%) and normal values of normacusis were detected in two out of 11 (18.2%). In two cases (18.2%) this kind of therapy did not influence hearing, but no deterioration occurred. The only determined complication was lasting perforation of eardrum even in the second control evaluation within the time lapse lf lone year after therapy. Eardrum perforation was observed in 6 examined ears (54.5%). In comparison with the similar studies published so far (Cochrane Database of Systematic Reviews – Steroids for idiopathic sudden sensorineural hearing loss), where hearing improvement was detected in 32% of patients treated with placebo, the improvement of hearing was reached in 61% of patients where general treatment with corticoids was applied (9).

Keywords:
sudden hearing disorder, local corticoid therapy, Microwick


Sources

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Audiology Paediatric ENT ENT (Otorhinolaryngology)
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