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Round Window Membrane Vibration May Increase the Effect of Intratympanic Dexamethasone Injection

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Author(s)
Soon Hyung ParkIn Seok Moon
Keimyung Author(s)
Park, Soon Hyung
Department
Dept. of Otorhinolaryngology (이비인후과학)
Journal Title
Laryngoscope
Issued Date
2014
Volume
124
Issue
6
Keyword
Round windowintratympanicvibrationsoundsudden hearing loss
Abstract
Objectives/Hypothesis


We investigated whether the round window membrane (RWM) vibration can facilitate dexamethasone perfusion via the RWM in patients with sudden hearing loss.


Study Design


Prospective study.


Methods


We first performed an in vitro study using a semipermeable membrane. In the subsequent in vivo study, 20 mice were randomized into two groups: an intratympanic dexamethasone injection (ITDI)-only group, and an ITDI with RWM vibration group. Concentration of dexamethasone was investigated using high performance liquid chromatography. Third, we performed a prospective clinical study. Fifty-five refractory sudden hearing loss patients were divided into two groups: those who received ITDI only (n = 36) and those who received ITDI with RWM vibration (n = 19). Final hearing assessments were conducted 2 months after salvage treatment.


Results


In the in vitro study, the concentration of dexamethasone increased with vibration time with the peak concentration observed at 3 minutes of vibration. In the in vivo study, ITDI with RWM vibration resulted in a significantly higher perilymph concentration of dexamethasone (7.68 ± 3.13 µg/ml) than that in the ITDI-only group (2.66 ± 1.73 µg/ml). In a clinical setting, the overall improvement in hearing was similar between the two groups. However, when we compared the speech discrimination score between the two groups, we found that the relative discrimination gain in the ITDI with RWM vibration group (18.11 ± 23.54%) was higher than that in the ITDI-only group (7.00 ± 15.54%) (P = 0.042).


Conclusion


RWM vibration can enhance the effect of intratympanic dexamethasone injection and is a viable treatment option for sudden hearing loss.


Levels of Evidence


N/A. Laryngoscope, 124:1444–1451, 2014
Keywords:

Round window;
intratympanic;
vibration;
sound;
sudden hearing loss
Keimyung Author(s)(Kor)
박순형
Publisher
School of Medicine
Citation
Soon Hyung Park and In Seok Moon. (2014). Round Window Membrane Vibration May Increase the Effect of Intratympanic Dexamethasone Injection. Laryngoscope, 124(6), 1444–1451. doi: 10.1002/lary.24482
Type
Article
ISSN
0023-852X
DOI
10.1002/lary.24482
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34636
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학)
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