Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4051
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
Sudden sensorineural hearing loss (SSNHL) is a common otologic disease in clinic while it rarely happens in pregnant women. The special status of maternal body as well as the insufficiency of research in this field causes a dilemma for both otologists and obstetricians. The doctors need a concrete treatment modality to follow when facing the problem.
hearing loss during pregnancy is a rare but severe clinical problem. Our attempt to improve their hearing thresholds motivated us to carry out this study. We aimed to help mothers deliver healthy babies safely with normal hearings.
The aim of this study was to demonstrate and promote our successful experience in treating SSNHL in pregnant patients. We hope more pregnant patients with SSNHL could be treated with timely intratympanic dexamethasone injections for their audiological impairments.
We performed a retrospective chart review for pregnant women who met the criteria for SSNHL. The treatment group received intratympanic dexamethasone (2.5 mg) q.o.d. four times and control group received no medication other than bed rest and medical observations. We documented their obstetric signs and pure-tone audiometry results before and after treatment and postpartum as indicators of safety and efficiency of the therapy.
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 clinical 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 PTAs at onset between the two groups were similar. After one week 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). All patients delivered healthy full-term neonates with an average Apgar score of 9.7 ± 0.5.
When SSNHL occurred in pregnant women, the doctors, the patients and the families were apt to sacrifice the hearings for the safety of neonates because of the lack of information and confidence for a safe and effective therapy. Unwilling to risk the babies’ well-being for uncertain hearing improvement, both doctors and patients chose to believe the spontaneous relief of symptoms or some treatments with potential detrimental effects. Based on sufficient literature review and field work, we were confident to propose that the intratympanic dexamethasone injection is a safe therapy for neonates as well as an efficient treatment in improving hearing impairments profoundly.
Our research needs more evidence with larger samples. We are making great efforts to conduct a multicenter RCTs on SSNHL in pregnant patients in order to verify our results. We hope, by publishing this paper, our experience will help more patients to restore their hearings.