Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2020; 8(18): 4051-4058
Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4051
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
Yan-Lu Lyu, Fan-Qian Zeng, Zhou Zhou, Min Yan, Wei Zhang, Ming Liu, Zhao-Yang Ke, 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
Author contributions: Lyu YL, Zeng FQ and Ke ZY conducted the studies, collected the data, and drafted the manuscript; Zhou Z, Yan M, Zhang W and Liu M participated in the study design and patient follow-up, and helped draft the manuscript; all authors read and approved the final version of the manuscript.
Supported by the Health and Family Planning Commission of Shenzhen Municipality, No. SZXJ2017065.
Institutional review board statement: This study was approved by the Committee of our Hospital.
Informed consent statement: All the patients were fully informed of the treatment modalities and the associated risks of medication or medical observations. All patients signed informed consent forms before they were enrolled in research.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhao-Yang Ke, MD, Chief Doctor, 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), No. 1017 North Dongmen Road, Luohu District, Shenzhen 518020, Guangdong Province, China. szrmebh@outlook.com
Received: May 11, 2020
Peer-review started: May 11, 2020
First decision: June 7, 2020
Revised: June 23, 2020
Accepted: August 12, 2020
Article in press: August 12, 2020
Published online: September 26, 2020
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: Sudden sensorineural hearing loss, Pregnancy, Intratympanic injection, Audiometry, Dexamethasone, Obstetrics

Core Tip: Sudden sensorineural hearing loss (SSNHL)rarely happens in pregnant women. The lack of understanding and guidelines in this condition has caused treatment dilemma. We retrospectively analyzed our experience with intratympanic dexamethasone injections for patients with sudden deafness during pregnancy and found out that the treatment group demonstrated a significantly better hearing threshold and greater improvement than control group after a total dose of 10 mg dexamethasone. Thus, we suggest that intratympanic dexamethasone injections should be applied as a safe and effective therapy for SSNHL during pregnancy.