Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy

Yan-Lu Lyu; Fan-Qian Zeng; Zhou Zhou; Min Yan; Wei Zhang; Ming Liu; Zhao-Yang Ke

doi:10.12998/wjcc.v8.i18.4051

Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy

World J Clin Cases. 2020 Sep 26;8(18):4051-4058. doi: 10.12998/wjcc.v8.i18.4051.

Authors

Yan-Lu Lyu¹, Fan-Qian Zeng¹, Zhou Zhou¹, Min Yan¹, Wei Zhang¹, Ming Liu¹, Zhao-Yang Ke²

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China.
² Department of Otorhinolaryngology-Head and Neck Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China. szrmebh@outlook.com.

Abstract

Background: As sudden sensorineural hearing loss (SSNHL) rarely occurs in pregnant women, there is a lack of knowledge and relevant research on its management.

Aim: To investigate the effect of intratympanic dexamethasone injection in the treatment of pregnant patients with SSNHL.

Methods: A retrospective chart review was made for the period between June 2017 and August 2019 at our Department of Otorhinolaryngology-Head and Neck Surgery. Pregnant women who met the criteria for SSNHL were included and grouped based on the therapeutic modalities. The treatment group received intratympanic dexamethasone (2.5 mg) q.o.d. for a total of four times, while the control group received no medication other than bed rest and medical observations. All the patients were under close care of obstetricians. Pure-tone audiograms were performed before and after treatment.

Results: Eleven patients who met the inclusion criteria were assigned to the treatment group (n = 7) and the control group (n = 4). The mean age of patients was 31.2 ± 3.8 years; the right ear was affected in seven (63.64%) cases. Two patients (18.2%) suffered from vertigo, 10 (90.9%) suffered from tinnitus and 6 (54.5%) suffered from aural fullness. The time from onset to clinic visit was relatively short, with a mean time of 1.3 ± 0.9 d. All the women were within the second or third trimester; the average gestation period was 26.0 ± 6.2 wk. The pure-tone averages at onset between the two groups were similar. After one wk of therapy, the treatment group had a curative rate of 57.1% and a significantly better hearing threshold and greater improvement compared to the control group (all P < 0.05). Some patients experienced transient discomfort from intratympanic injections that disappeared after getting rest, while none had permanent complications. All patients delivered healthy full-term neonates with an average Apgar score of 9.7 ± 0.5.

Conclusion: Intratympanic dexamethasone injections can be used as a first-line therapy in pregnant women with SSNHL.

Keywords: Audiometry; Dexamethasone; Obstetrics; Pregnancy, Intratympanic injection; Sudden sensorineural hearing loss.