Intratympanic Corticosteroids: A Systematic Review

Abstract

Many otologic diseases as sudden sensorineural hearing loss and Méniére disease had been treated with systemic corticosteroids, which have many potentially serious adverse effects. The intratympanic corticosteroids are an alternative for the treatment of these diseases of the internal ear, having less systemic adverse events and better pharmacokinetic profile, which may promote its therapeutic effects. We made a systematic review searching the existing evidence about the utility and rationality of the clinical use of this therapy. The few good quality existing trials show a similar effectiveness of the intratympanic corticosteroids compared with the systemic ones for primary therapy and a superiority compared with placebo for rescue therapy. There is a great variation between the different protocols of administration of the intratympanic corticosteroids and the type of corticosteroid used. Considering the high spontaneous resolution of the symptoms in this pathologies and the disparity between the results in the different trials its difficult to establish the real utility of this therapy. More good quality studies with standardized protocols are needed to determine the best clinical application for this kind of therapy.