Intratympanic steroids very rarely cause changes in serum glucose levels in patients with diabetes . They may also be given to patients with cataracts, myasthenia gravis, and glaucoma . The principal risk appears to be a persistent tympanic membrane perforation at the injection site. This complication, however, is rare and frequently resolves spontaneously or with a paper patch myringoplasty in the office. Existing studies showed considerable variability in the dose and concentration of steroids administered, the timing, frequency, and total number of injections (ranging from one to several to continuous); and drug selection (dexamethasone and methylprednisolone) . This high degree of variability makes it difficult to compare the results across studies. Despite this variability, 3 of the 4 RCTs evaluating intratympanic steroids as salvage therapy found that IT steroids improved hearing outcomes beyond placebo. Hearing improvement occurred in 53% to 90% of patients [29,30] Table 2.
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Sudden hearing loss may improve, stay the same, or potentially get worse. Occasionally, the hearing loss may be permanent. Early treatment of this condition is of utmost importance. Avoidance of loud noise is imperative, both in the affected ear and the unaffected ear. It is common that the affected ear will be more sensitive to sounds after sudden hearing loss. If hearing loss persists, a hearing aid may be indicated. If complete loss of hearing occurs in one ear, a special hearing aid or an implanted bone anchored hearing device may be helpful.