EFFECT OF INTRA-TYMPANIC PLATELET RICH PLASMA AND STEROID INJECTION ON SENSORINEURAL HEARING LOSS

Authors

  • Amna Raza CMH Sialkot, Pakistan Author
  • Sohail Aslam CMH Sialkot, Pakistan Author

DOI:

https://doi.org/10.71000/1wdvh698

Keywords:

Dexamethasone, Middle Ear, Platelet Rich Plasma, Sensorineural Hearing Loss, Tympanic Membrane., Steroid Therapy, Tympanic Injection.

Abstract

Background: Sensorineural hearing loss (SNHL) is one of the most prevalent forms of hearing impairment worldwide, often resulting from irreversible damage to cochlear structures. Inflammation has been identified as a critical factor in its pathogenesis. While corticosteroids are the conventional therapeutic choice due to their anti-inflammatory effects, platelet-rich plasma (PRP) has recently emerged as a promising alternative because of its regenerative and anti-inflammatory properties.

Objective: To compare the frequency of hearing improvement in patients with SNHL treated with intra-tympanic platelet-rich plasma versus intra-tympanic dexamethasone injection.

Methods: This quasi-experimental study was conducted at Combined Military Hospital, Sialkot, from January to June 2023. Ninety patients aged ≥18 years with documented SNHL and intact tympanic membranes were enrolled and non-randomly allocated into two groups: Group-P (intra-tympanic PRP) and Group-S (intra-tympanic dexamethasone). Each patient received four weekly injections of their assigned treatment. Pure tone audiometry (PTA) was performed at baseline and two weeks after the final injection. Hearing improvement was defined as a ≥10 dB gain in PTA. Data were analyzed using SPSS version 22, with p ≤ 0.05 considered statistically significant.

Results: The median age was 35.00 (IQR: 11.25) years; 58 (64.4%) were male and 32 (35.6%) were female. Pre-injection PTA values were comparable: 52.00 (7.00) dB in Group-P and 52.00 (7.50) dB in Group-S (p = 0.721). Post-injection PTA values showed significant improvement in both groups: 35.00 (16.50) dB in Group-P and 38.00 (6.50) dB in Group-S (p = 0.023). Hearing improvement was achieved in 32 (71.11%) patients in Group-P compared to 23 (51.11%) in Group-S (p = 0.041).

Conclusion: Intra-tympanic PRP demonstrated superior efficacy compared to dexamethasone in improving hearing outcomes among patients with SNHL.

Author Biographies

  • Amna Raza, CMH Sialkot, Pakistan

    Postgraduate resident ENT, Department of Otorhinolaryngology, Head and Neck Surgery, CMH Sialkot, Pakistan.

  • Sohail Aslam, CMH Sialkot, Pakistan

    Classified ENT specialist, Department of Otorhinolaryngology, Head and Neck Surgery, CMH Sialkot, Pakistan.

References

GBD 2019 Hearing Loss Collaborators. Hearing loss prevalence and years lived with disability, 1990-2019: findings from the Global Burden of Disease Study 2019. Lancet. 2021;397(10278):996-1009.

Haile LM, Orji AU, Reavis KM, Briant PS, Lucas KM, Alahdab F, et al.; GBD 2019 USA Hearing Loss Collaborators. Hearing loss prevalence, years lived with disability, and hearing aid use in the United States From 1990 to 2019: Findings from the Global Burden of Disease Study. Ear Hear. 2024;45(1):257-267.

Borre ED, Kaalund K, Frisco N, Zhang G, Ayer A, Kelly-Hedrick M, et al. The impact of hearing loss and its treatment on health-related quality of life utility: a systematic review with meta-analysis. J Gen Intern Med. 2023;38(2):456-479.

Alrasheed AM, Junaid M, Ardi KT, Ebraheem FAM, Alaidaroos OZ. Quality of life among adults with hearing loss who were prescribed hearing aids in Aseer Province, Saudi Arabia: A cross-sectional tertiary center-based study. Cureus. 2023;15(9): e45922.

Lye J, Delaney DS, Leith FK, Sardesai VS, McLenachan S, Chen FK, et al. Recent therapeutic progress and future perspectives for the treatment of hearing loss. Biomedicines. 2023;11(12):3347.

Tripathi P, Deshmukh P. Sudden sensorineural hearing loss: a review. Cureus. 2022;14(9): e29458.

Qian ZJ, Chang KW, Ahmad IN, Tribble MS, Cheng AG. Use of diagnostic testing and intervention for sensorineural hearing loss in US children from 2008 to 2018. JAMA Otolaryngol Head Neck Surg. 2021;147(3):253-260.

Lee SY, Seo HW, Jung SM, Lee SH, Chung JH. Assessing the accuracy and reliability of application-based audiometry for hearing evaluation. Sci Rep. 2024; 14:7359.

Chen J, Fraser-Kirk K. Management of sudden sensorineural hearing loss: A time-critical diagnosis. Aust J Gen Pract. 2024;53(11_Suppl): S14-S18.

Tom SM, Sachdeva K, Kabade MV, Shukla A, Raj LV. Clinicoaudiological evaluation of hearing improvement in patients with sensorineural hearing loss using intratympanic platelet rich plasma versus steroid injection. Int J Otorhinolaryngol Head Neck Surg. 2022;8(4):327-332.

do Amaral JB, Peron KA, Soeiro TLT, Scott MCP, Hortense FTP, da Silva MD, et al. The inflammatory and metabolic status of patients with sudden-onset sensorineural hearing loss. Front Neurol. 2024; 15:1382096.

Frosolini A, Franz L, Daloiso A, Lovato A, de Filippis C, Marioni G. Digging into the role of inflammatory biomarkers in sudden sensorineural hearing loss diagnosis and prognosis: a systematic review and meta-analysis. Medicina (Kaunas). 2022;58(7):963

Halevy N, Elias B, Shilo S, Muhanna N, Handzel O, Oron Y, et al. Real-life safety of systemic steroids for sudden sensorineural hearing loss: a chart review. Eur Arch Otorhinolaryngol. 2022;279(10):4787-4792

Huynh PP, Saba ES, Hoerter JE, Jiang N. Steroid efficacy on audiologic recovery in patients with sudden sensorineural hearing loss and vestibular schwannoma: a retrospective review. Otol Neurotol. 2023;44(8):780-785.

Berlinberg EJ, Swindell H, Patel HH, Zabat M, Forlenza EM, Cancienne J, et al. The epidemiology of platelet-rich plasma injections from 2010 to 2020 in a large US commercial insurance claims database: a recent update. J Am Acad Orthop Surg. 2023;31(3): e135-e147.

Yadav S, Srivastava S, Singh G. Platelet-rich plasma exhibits anti-inflammatory effect and attenuates cardiomyocyte damage by reducing NF-κB and enhancing VEGF expression in isoproterenol induced cardiotoxicity model. Environ Toxicol. 2022;37(4):936-953.

Khanal P, Acharya S, Lageju N. Pattern of hearing loss among patients attending ent department of a tertiary hospital in Nepal: A Retrospective Study. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 1):559-562.

Villavisanis DF, Berson ER, Lauer AM, Cosetti MK, Schrode KM. Sex-based differences in hearing loss: perspectives from non-clinical research to clinical outcomes. Otol Neurotol. 2020;41(3):290-298

Yaseen NK, Al-Ani RM, Ali Rashid R. COVID-19-related sudden sensorineural hearing loss. Qatar Med J. 2021;2021(3):58.

Gupta PK, Bhan C, Yadav PK, Sharma SK, Singh S, Tiwari SK. Comparative study of effectiveness of intratympanic steroid injection vs intratympanic PRP in sensorineural hearing loss. Int J Sci Res. 2023;12(2):44-46.

Sherif AMH, Alawady MK, Mahfouz RM, Abbas AI, Ali HF. Comparative study between intratympanic steroid injection and intratympanic platelet rich plasma (PRP) injection in sudden sensorineural hearing loss (SSNHL). Al-Azhar Int Med J. 2024;5(4):41.

Gupta N, Patel M, Nagpal T, Shah A, Jain A. Efficacy of intratympanic steroid vs. platelet-rich plasma in sudden sensorineural hearing loss: a randomized controlled trial. Afr J Biol Sci. 2024;6(13):882-885.

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Published

2025-06-16