Treatment of sudden @entity1274 with transtympanic injection of XXXX as single therapy: a randomized clinical study.

@entity1 @entity229 @entity134 @entity619 @entity1274 @entity230
The aim of this study was to verify the efficacy and the safety of transtympanic @entity619 to treat sudden @entity1274 as first and single drug method. Considering ethical implication of performing a mininvasive procedure on middle ear, we matched such proposed treatment with systemic @entity229 administration that represents the widest adopted protocol. Randomized prospective study was conducted. The inclusion criterion was a sudden @entity1274 of at least 30  dB across three contiguous frequencies over a period of 24  h. Group A received transtympanic @entity134 injections; Group B received oral administration of @entity230 . 25 @entity1 were treated with transtympanic therapy whereas 21 underwent systemic treatment. The mean of initial PTA was 59  dB for the whole series: 65  dB for group A and 51  dB for group B. The recovery better than 10  dB was obtained in 80% of @entity1 of group A and in 17 81% of @entity1 of group B, with a total of 80.5%. The mean relative gain in PTA was 41.16% in the group A and 44.7% in the group B. In the frequencies tested (0.5, 1, 2, and 4  kHz) PTA improvements after transtympanic treatment were higher than after systemic treatment, but these differences were not statistically significant (P  =  0.61). Both transtympanic and systemic treatment had similar clinical recovery times. This prospective randomized clinical study showed good result in terms of hearing recovery, better than the expected results of the simple observation without treatment. We can consider transtympanic administration as a first line treatment, because of the statistical analysis confirmed similar results with systemic therapy, reducing possible side effects of systemic drug administration. The delay of treatment does not influence the outcome, allowing treating @entity1 within 10  days of onset.
