The use of intratympanic injection for the treatment of sudden sensorineural hearing loss in Japan

Abstract

Intratympanic injection therapy is a well-known treatment for inner ear diseases, including sudden sensorineural hearing loss (SSNHL). However, it is not widely performed in Japan, as it is not covered by insurance. Therefore, a questionnaire survey on intratympanic injection was conducted.

We sent out questionnaires to 84 delegates from the Japan Otological Society, and responses were obtained from 76 (90.5%). Fifty-three (69.7%) responded that they had treated patients with SSNHL using intratympanic steroid (ITS), but only nineteen (35.8%) out of them actively recommended ITS to patients with SSNHL. Ten (18.9%) responded that ITS had been approved for specific clinical trials by institutional review boards. Fifty-eight (76.8%) responded that ITS would be more aggressively used in treating patients with SSNHL.

It is suggested that the lack of insurance coverage of ITS is a reason why it is not widely used for patients with SSNHL in Japan. In the “Clinical Practice Guideline: Sudden Hearing Loss” published by the American Academy of Otolaryngology-Head and Neck Surgery, ITS is considered an “option” as an initial therapy and “recommendation” as a salvage therapy after systemic steroid. In the “Clinical Practice Guidelines for the Diagnosis and Management of Acute Sensorineural Hearing Loss” published by Japan Audiological Society in 2018, ITS is considered “Grade C1” as an initial therapy and “Grade B” as a salvage therapy. Additionally, ITS is also used in treating Meniere’s disease and Bell’s palsy. If ITS is covered by insurance, it will be widely used in treating various diseases.