Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2025; 16(5): 99576
Published online May 15, 2025. doi: 10.4239/wjd.v16.i5.99576
Therapeutic effectiveness of intratympanic and retroauricular methylprednisolone sodium succinate for refractory sudden sensorineural hearing loss in diabetic patients
Dong Li, Fei Qiao, Jun Dai, Min Xu, He-Yan Gong, Hui-Ming Yang, Jing-Cheng Li, De Huai
Dong Li, Jun Dai, He-Yan Gong, Hui-Ming Yang, De Huai, Department of Otorhinolaryngology Head and Neck surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University (The Second People's Hospital of Huai'an), Huai’an 223002, Jiangsu Province, China
Fei Qiao, Department of Otolaryngology Head and Neck Surgery, Jinhu County People's Hospital, Huai’an 211600, Jiangsu Province, China
Min Xu, Department of Radiology, The Affiliated Huai'an Hospital of Xuzhou Medical University (The Second People's Hospital of Huai'an), Huai’an 223002, Jiangsu Province, China
Jing-Cheng Li, Department of Otorhinolaryngology, The Affiliated Huai'an Hospital of Yangzhou University (The Fifth People's Hospital of Huai'an), Huai’an 223300, Jiangsu Province, China
Co-first authors: Dong Li and Fei Qiao.
Co-corresponding authors: Jing-Cheng Li and De Huai.
Author contributions: Li D and Qiao F designed the research and wrote the first manuscript; Li D, Qiao F, Dai J, Xu M, Gong HY, Yang HM, Huai D and Li JC contributed to conceiving the research and analyzing data; Li D and Qiao F conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript. Li D and Qiao F contributed equally to this work and are co-first authors. Li D and Qiao F contributed equally to this work and are co-first authors. Both Li JC and Huai D have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. Li D and Qiao F applied for and obtained the funds for this research project. Li D and Qiao F conceptualized, designed, and supervised the whole process of the project. Li D and Qiao F searched the literature, revised and submitted the early version of the manuscript. Li JC and Huai D were instrumental and responsible for data re-analysis and re-interpretation, figure plotting, comprehensive literature search, preparation and submission of the current version of the manuscript. This collaboration between Li JC and Huai D is crucial for the publication of this manuscript and other manuscripts still in preparation.
Supported by 2023 Science and Technology Innovation Program (Key Laboratory of Sleep Respiratory Disorders) in Huai'an, No. HAP202304.
Institutional review board statement: This study was approved by the Ethic Committee of The Second People's Hospital of Huai'an (Approval No. HEYLL202414).
Informed consent statement: All the study subjects provided informed consent.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Cheng Li, Department of Otorhinolaryngology, The Affiliated Huai'an Hospital of Yangzhou University (The Fifth People's Hospital of Huai'an), No. 1 Huaihe Road, Huaiyin District, Huai’an 223300, Jiangsu Province, China. jingchengl@126.com
Received: November 13, 2024
Revised: February 17, 2025
Accepted: March 21, 2025
Published online: May 15, 2025
Processing time: 162 Days and 23.2 Hours
Abstract
BACKGROUND

Managing refractory sudden sensorineural hearing loss (RSSHL) in patients with diabetes mellitus (DM) presents significant therapeutic challenges, highlighting the importance of identifying effective treatment strategies.

AIM

To analyze the therapeutic effectiveness of intratympanic injection plus retroauricular injection for RSSHL complicated with DM.

METHODS

This study included 84 patients with RSSHL complicated with DM from April 2021 to April 2024, all receiving routine treatment. Participants were categorized into the control group (40 cases), receiving an intratympanic injection of methylprednisolone sodium succinate (MPSS), and the research group (44 cases), treated with retroauricular MPSS injection the next day in addition to the treatment administered in the control group. The efficacy, adverse reactions (tympanic membrane perforation, middle ear infections, burning sensation, vertigo, and tinnitus), blood glucose (BG) [fasting BG (FBG), 2-hour postprandial BG (2hPBG), and glycosylated hemoglobin (HbA1c)], hearing thresholds at different frequencies (250 Hz, 500 Hz, and 1000 Hz), serum biochemical indexes [interleukin (IL)-6, C-reactive protein (CRP), and procalcitonin (PCT)], and quality of life assessed by the short-form 36 item health survey (SF-36) were comparatively analyzed.

RESULTS

The research group demonstrated a markedly higher total effectiveness rate (81.82% vs 60.00%, P = 0.027) and a comparable incidence of total adverse reactions than the control group. Further, the research group exhibited notably reduced FBG, 2hPBG, HbA1c, IL-6, CRP, and PCT post-treatment (P < 0.01), which were lower compared with the pre-treatment levels and the control group (P < 0.05), as well as reduced hearing thresholds at different frequencies (250 Hz, 500 Hz, and 1000 Hz, P < 0.05). Furthermore, the post-treatment SF-36 scores of the research group in terms of energy, social functioning, role functioning, physical functioning, mental health, and overall health were all significantly improved than the pre-treatment levels and the control group (P < 0.05).

CONCLUSION

The above results indicate that intratympanic plus retroauricular injections of MPSS are effective in treating RSSHL complicated with DM without increasing the incidence of adverse reactions, which has a health promotion value.

Keywords: Intratympanic injection; Retroauricular injection; Refractory sudden hearing loss; Diabetes mellitus; Therapeutic effectiveness

Core Tip: Studies on the efficacy of combined intratympanic and retroauricular injection of methylprednisolone sodium succinate (MPSS) for refractory sudden sensorineural hearing loss (RSSHL) complicated with diabetes mellitus (DM) remains limited. Herein, we comprehensively assessed treatment outcomes, adverse effects, blood glucose (BG) levels, hearing thresholds across various frequencies, serum biochemical markers, and quality of life. The results indicate that intratympanic injection combined with retroauricular administration of MPSS significantly improves therapeutic efficacy in patients with RSSHL complicated with DM. This approach not only improves BG control and suppresses systemic inflammation but also enhances quality of life without increasing the overall risk of adverse effects. These results provide valuable information and a potential framework for optimizing treatment strategies in this patient population.