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עמוד בית
Thu, 02.02.23

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February 2019
Einat Levy MSc MD, Eyal Sela MD, Vadim Letichevsky MD and Ohad Ronen MD

Background: The currently accepted treatment for idiopathic sudden sensorineural hearing loss (ISSHL) is systemic steroids as first-line and intratympanic steroids as salvage therapy. Intratympanic (IT) treatment is applied worldwide in many different ways with no universally accepted protocol.

Objectives: To present the current disparity in ISSHL management and to discuss the necessity for establishing a common national protocol.

Methods: In 2014 we conducted a national survey by sending questionnaires on ISSHL management to otologists in every otolaryngology department in the country.

Results: The majority of otolaryngology departments (56%) admit patients with sudden sensorineural hearing. Almost two-thirds (61%) of departments recommend supplementary initial treatment in addition to systemic steroids. None of the medical centers offer intratympanic steroid treatment as primary therapy, but 94% offer this treatment as a salvage therapy. Fewer than half the medical centers (44%) consider the maximal period for intratympanic therapy to be 4 weeks since hearing loss appears. Almost half (48%) the departments use intratympanic steroids once every 5–7 days, usually in an ambulatory setting. Almost half (44%) the medical centers tend to use not more than four courses of IT steroids. In 44% of departments an audiogram is performed at the beginning and at the end of the intratympanic course.

Conclusions: Our results demonstrate a variability among Israeli medical centers in many aspects of intratympanic treatment. We believe this reinforces the need for a comparative international study in order to establish a standard protocol.

February 2012
N. Moustafa-Hawash, T. Smolkin, A. Ilivitzki, A. Zimberg-Bossira, A. Gildish, R. Gershoni-Baruch and I.R. Makhoul
January 2007
Shihada, J. Ben-David, A. Brodsky, E. Toubi and M. Luntz.
April 2002
Gil Siegal, MD, Jacob Braun, MD, Avraham Kuten, MD, Tzahala Tzuk-Shina, MD, Louise M. Lev, MD, Ines Misselevitch, MD and Michal Luntz, MD
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