Residual Perforation Risk Assessment of Intratympanic Steroids via Tympanostomy Tube Versus Transtympanic Injections

Liam Simani, Shahaf Shilo, Yahav Oron, Rani A. Eta, Ophir Handzel, Nidal Muhanna, Anton Warshavsky, Gilad Horowitz, Omer J. Ungar*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objectives/Hypothesis: To investigate the risk of residual tympanic membrane (TM) perforation after intratympanic (IT) steroidal treatment administered via transtympanic injection compared with trans-tympanostomy tube (TyT). Study Design: Case series, systematic review and meta analysis. Methods: Data were retrieved from the medical files of an original cohort of all consecutive patients with sudden sensorineural hearing loss necessitating IT steroidal treatment in a tertiary medical center between January 1, 2016 and November 20, 2020. A systematic literature search of “MEDLINE” via “PubMed,” “Embase,” and “Web of Science” on comparable published cases was performed and meta-analysis was established. Results: Eighteen studies describing 818 ears were included in the quantitative meta-analysis in addition to a local cohort of 140 ears. The proportion of residual TM perforation was 1.11% and 1.14% (95% confidence interval: 0.01%–3.27% and 0.028%–2.38%) in the TyT and trans-tympanic groups, respectively, suggesting no significant difference in residual TM perforation risk between these techniques. Conclusion: IT steroid therapy via trans-TyT is not associated with more residual perforations than IT steroid therapy via transtympanic injections. Level of Evidence: NA Laryngoscope, 131:E2583–E2591, 2021.

Original languageEnglish
Pages (from-to)E2583-E2591
JournalLaryngoscope
Volume131
Issue number9
DOIs
StatePublished - Sep 2021

Keywords

  • Tympanostomy tube
  • intratympanic steroids
  • residual perforation
  • sudden sensorineural hearing loss
  • tympanic membrane perforation

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