SYSTEMIC SIDE EFFECTS OF TRANSTYMPANIC STEROIDS

✍ Scribed by Ashley B. Robey; Trish Morrow; Gary F. Moore

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 333 KB
• Volume: 120
• Category: Article
• ISSN: 0023-852X
• DOI: 10.1002/lary.21684

✦ Synopsis

Objective: Review largest series of patients treated with transtympanic steroids, including outcomes, steroid dosing and adverse outcomes. Review first reported cases of systemic side effects from transtympanic steroids. Methods: A retrospective case series of 166 patients who underwent placement of transtympanic Silverstein tube with microwick for steroid administration was reviewed. Results: 5/166 patients developed systemic side effects, 9/166 patients developed local side effects. 48/166 (29%) of patients had a persistent perforation after therapy. The percent of patients with improvement as a function of symptoms: hearing loss 42%, tinnitus 56%, vertigo 68%, aural fullness 25% and dysequilibrium 66%. Conclusions: While our study revealed a significant risk of persistent tympanic membrane perforation, the incidence of systemic and local side effects from transtympanic steroid administration is low.

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RESULTS

METHODS & MATERIALS CONCLUSIONS

-Selection of steroid dose (average or maximum) does not appear to be associated improved outcomes.

-Duration of steroid therapy does not appear to be associated with improved outcomes.

-While there is a significant risk of persistent perforation (29%), transtympanic steroids are associated with a small risk of adverse side effects [local (9%) and systemic (3%)].