For some people, the intravenous administration of cortisone in the case of sudden hearing loss, dizziness or ringing in the ears is considered problematic because of side effects. This applies, for example, to diabetics with poor medication control, old people, but also to certain heart diseases. Sometimes a previous cortisone therapy in the form of an infusion may not have had the desired effect. Intratympanic steroid injection (ITSI) is another treatment option. Here, a high-dose cortisone preparation is injected through the anaesthetised eardrum directly into the middle ear and delivers its effect directly to the diseased inner ear.
In the current S1 guideline of the Association of the Scientific Medical Societies (AWMF), high-dose glucocorticoid therapy as an intravenous infusion and / or injection directly into the middle ear is recommended for a hearing loss (as of April 2021).
Procedure: What happens during the procedure?
The procedure is done under local anaesthetic. A tiny incision is made in the eardrum. The middle ear can now be viewed under endoscopic control (the endoscope is 0.8 to 4 mm in diameter). Prednisolone is then injected into the middle ear under endoscopic control. The procedure takes between 5 and 20 minutes.
Prospects of success: Does the intervention really make a difference?
The treatment of hearing loss shows a response rate of over 80 % when indicated correctly (see Performance Report at www.acqua-klinik.de). With other diseases, the intervention is less successful. This is due to diseases that are localised in the inner ear and only respond fully to the therapy under favourable circumstances. Occasionally, a repetition of the active substance injection or other therapy steps are necessary.