Intratympanic steroids shot is it worth it

The remaining two procedures, vetibular neurectomy and labyrinthectomy, are ways of eliminating the balance function of the faulty ear. It is known that individuals will function better with one normal balance system than with one normal and one faulty system. The labyrinthectomy is a procedure in which the mastoid bone is removed and the inner ear is eliminated. This procedure is for patients that have lost usable hearing in the affected ear, as it entails removing all function of the inner ear, including hearing and balance. The change from having two balance systems to having one balance system alone does require a recovery or "compensation" period. It takes the brain a period of weeks to figure out that only one system is active and that it is no longer receiving information from the faulty system which it had come to expect. The second procedure, the vestibular neurectomy, is a good option if the hearing is good in the ear with the failing balance system. In this surgical procedure, the balance nerve (vestibular nerve) is cut between the inner ear and the brain. The inner ear is completely preserved but the faulty balance information is not able to reach the brain and cause the vertigo. Like the labyrinthectomy, this procedure requires a recovery period while the brain "figures out" the new situation.

Clinically, the success rate of Intratympanic steroid therapy in patients with SHL is variable in the literature and the available studies are limited to retrospective and non-controlled prospective ones. In those studies steroids were used in various concentrations, regimens and delivery methods and their effectiveness have not been established due to the lack of randomized controlled trials. There have been some studies in the literature that discussed the effectiveness of Intratympanic steroid therapy as a salvage mode of therapy in patients who failed to respond to oral steroids (Herr & Marzo 2005, Slattery et al 2005).

People who experience a sudden hearing loss (SSNHL) are often treated with systemic steroids, which are taken orally. Studies however show that people with sudden sensorineural hearing loss (SSNHL) who do not respond to this treatment can benefit from intratympanic steroid injections. Studies carried out at universities in USA and Thailand show intratympanic steroid injections to be very effective and that the treatment does not have any side-effects.

Dr. David Haynes from Vanderbilt University Medical Center, Nashville, USA, carried out the study of 40 people who had experienced sudden sensorineural hearing loss (SSNHL). Overall, 40% showed some kind of improvement when treated with intratympanic steroid injections.

For the secondary outcomes, we carried out two pooled analyses. We found statistically significant results for loss or gain of hearing . Hearing was decibels better in the placebo group compared to the positive pressure therapy group ( MD ) (95% CI to ; two studies, 123 participants). The severity of tinnitus and perception of aural fullness were either not measured or inadequate data were provided in the included studies. For the secondary outcome functional level , it was not possible to perform a pooled analysis . One included study showed less functional impairment in the positive pressure group than the placebo group (AAO-HNS criteria, one- to six-point scale: MD -, 95% CI - to -, 40 participants); another study did not show any significant results. In addition to the predefined secondary outcome measures, we included sick days as an additional outcome measure, as two studies used this outcome measure and it is a complementary measurement of impairment due to Ménière's disease. We did not find a statistically significant difference in sick days. No complications or adverse effects were noted by any study .

Intratympanic steroids shot is it worth it

intratympanic steroids shot is it worth it

For the secondary outcomes, we carried out two pooled analyses. We found statistically significant results for loss or gain of hearing . Hearing was decibels better in the placebo group compared to the positive pressure therapy group ( MD ) (95% CI to ; two studies, 123 participants). The severity of tinnitus and perception of aural fullness were either not measured or inadequate data were provided in the included studies. For the secondary outcome functional level , it was not possible to perform a pooled analysis . One included study showed less functional impairment in the positive pressure group than the placebo group (AAO-HNS criteria, one- to six-point scale: MD -, 95% CI - to -, 40 participants); another study did not show any significant results. In addition to the predefined secondary outcome measures, we included sick days as an additional outcome measure, as two studies used this outcome measure and it is a complementary measurement of impairment due to Ménière's disease. We did not find a statistically significant difference in sick days. No complications or adverse effects were noted by any study .

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