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How long should patients remain in the supine treatment position after intratympanic dexamethasone injection?

Authors
 Soon H. Park  ;  Changhun Park  ;  Jin Y. Seo  ;  Jae H. Cho  ;  In S. Moon 
Citation
 LARYNGOSCOPE, Vol.124(12) : 2807-2810, 2014 
Journal Title
LARYNGOSCOPE
ISSN
 0023-852X 
Issue Date
2014
MeSH
Animals ; Audiometry, Pure-Tone ; Dexamethasone/administration & dosage* ; Disease Models, Animal ; Female ; Follow-Up Studies ; Hearing/physiology* ; Hearing Loss, Sensorineural/drug therapy* ; Hearing Loss, Sensorineural/physiopathology ; Hearing Loss, Sudden/drug therapy* ; Hearing Loss, Sudden/physiopathology ; Injections ; Mice ; Mice, Inbred ICR ; Prospective Studies ; Supine Position* ; Time Factors ; Treatment Outcome ; Tympanic Membrane
Keywords
Intratympanic ; position ; sudden hearing loss
Abstract
OBJECTIVES/HYPOTHESIS:
Intratympanic dexamethasone injection (ITDI) is a widely accepted treatment for patients with sudden hearing loss. We investigated the appropriate patient wait time in the supine treatment position after ITDI.
STUDY DESIGN:
Prospective study.
METHODS:
In an in vivo animal study, 24 mice were injected intratympanically with dexamethasone. Perilymphatic fluid was sampled at 5, 10, 15, 20, 25, and 30 minutes postinjection. The dexamethasone concentration was analyzed using high-performance liquid chromatography. In a separate prospective clinical study, 79 patients with refractory sudden hearing loss underwent intratympanic injection. After the injection, patients remained in the supine position with the head rotated 45° to the unaffected side. Patients were divided into two groups according to the wait time in this treatment position postinjection: 30 minutes (n = 47) and 10 minutes (n = 32). Final hearing assessments were conducted 2 months after salvage treatment.
RESULTS:
In the in vivo animal study, the perilymphatic concentration of dexamethasone showed no significant increase after 10 minutes. In the clinical setting, hearing improvement according to Siegel's criteria was similar in the 30-minute (14/47) and 10-minute (10/32) groups (P = 0.999). No significant differences in relative hearing gain was observed between the two groups (13.80 ± 19.9 dB and 12.57 ± 14.9 dB, respectively; P = 0.766).
CONCLUSION:
We suggest that 10 minutes is a sufficient time to remain in the supine treatment position after ITDI in patients with sudden hearing loss.
LEVEL OF EVIDENCE:
N/A. Laryngoscope, 124:2807-2810, 2014.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/lary.24872/abstract
DOI
10.1002/lary.24872
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Moon, In Seok(문인석) ORCID logo https://orcid.org/0000-0002-3951-5074
Seo, Jin Y.(서진영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100373
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