Transtympanic steroid injections

Some causes of vertigo and hearing loss can be treated effectively with steroids.  An example of this would be sudden hearing loss from inner ear nerve inflammation.  Traditionally, oral steroids are used to treat this condition.  When oral steroids are not effective or the patient does not tolerate them, or another medical condition does not allow a patient to use them, an alternative is a steroid perfusion.  A very small quantity of steroid solution is placed in the middle ear through a small hold in the eardrum under local anesthesia in the office.  This allows the steroid to be absorbed directly into the inner ear - sometimes with more effectiveness than steroid pills.  There are some conditions such as vertigo from certain types of Meniere’s disease that also sometimes will respond to a steroid perfusion.

AB - Objective: Review largest series of patients treated with transtympanic steroids, including outcomes, steroid dosing and adverse outcomes. Review first reported cases of systemic side effects from transtympanic steroids. Methods: A retrospective case series of 166 patients who underwent placement of transtympanic Silverstein tube with microwick for steroid administration was reviewed. Results: 5/166 patients developed systemic side effects, 9/166 patients developed local side effects. 48/166 (29%) of patients had a persistent perforation after therapy. The percent of patients with improvement as a function of symptoms: hearing loss 42%, tinnitus 56%, vertigo 68%, aural fullness 25% and dysequilibrium 66%. Conclusions: While our study revealed a significant risk of persistent tympanic membrane perforation, the incidence of systemic and local side effects from transtympanic steroid administration is low.

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Transtympanic steroid injections

transtympanic steroid injections


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