Intratympanic steroid therapy using the Silverstein Microwick for refractory sudden sensorineural hearing loss increases speech intelligibility.

OBJECTIVE: To determine whether delivery of methylprednisolone to the round window (administered for 10 days after the onset of the hearing loss) can improve hearing and, in particular, speech intelligibility, after the failure of conventional treatment for idiopathic sudden sensorineural hearing loss. RESULTS: Of the 26 patients enrolled in this non-randomized retrospective study, 14 patients (54%) showed an improvement in the pure tone average (PTA) and 12 remained unchanged. The topical steroid therapy brought about an overall improvement in PTA of 13.5 +/- 7.3 dB for the 26 patients enrolled. The auditory capacity index, defined as the mean speech discrimination score obtained at 40, 55 and 70 dB, improved by 24.2 +/- 8.7% in 26 patients. Among the 12 patients with a stable PTA, 9 showed an increase in speech intelligibility. CONCLUSION: Local administration of steroids to the inner ear through the round window route improves hearing and speech intelligibility in patients after failure of conventional therapy.