The effect of direct application of dexamethasone on the round window membrane in patients with sudden sensorineural hearing loss

Abstract

Objective: The aim of this study was to test the effect of direct application of dexamethasone on the round window (RW) after its adequate exposure following a transcanal approach in patients with sudden sensorineural hearing loss (SSNHL). Study design: This investigation was designed to be a prospective cohort study. Patients and methods: This study included eighteen adult patients with SSNHL who attended our outpatient clinic at Alexandria Main University Hospital between 1 July 2015 and 1 July 2016. Under general anesthesia the small tympanomeatal flap was elevated to visualize the RW. If it was fully exposed, dexamethasone (4 mg/ml) was applied directly over a piece of gel foam; if not fully exposed the overhang was removed first and then dexamethasone was applied. After 2 weeks, a repeat audiogram was taken in all patients in order to evaluate the efficacy of the treatment on their hearing ability. Results: Post-treatment assessment revealed 50% of patients with variable levels of improvement, whereas 50% did not respond to the given treatment. Of the patients showing improvement, 16.7% had normal hearing levels restored. Thus, direct application of dexamethasone on the RW membrane after its adequate exposure may reverse the hearing deficits in a few patients with SSNHL. Conclusion: There is a definitive improvement in hearing in patients with SSNHL on direct application of dexamethasone on the RW membrane after its adequate exposure in patients.