Sudden Deafness – Steroids, MicroWick

What causes it?

Sudden deafness is believed to be caused by either a virus, a tiny blood clot in the inner ear, Meniere’s disease or, rarely, a tumor growing on the hearing nerve.

How is it treated?

It is best treated by an Otolaryngologist as soon as possible after the hearing loss occurs. The treatment options are to give high doses of steroids (Prednisone) for 2 weeks, followed by a tapering dose.

Another option is the placement of the steroids directly into the ear using a direct needle injection. This may require several re-injection procedures over the course of a few weeks.

The MicroWick is an ingenious method to deliver the steroid into the middle ear without causing the weekly discomfort of an injection. The MicroWick is placed through the eardrum after anesthetizing the ear with a local anesthetic, zylocaine. The procedure takes about 15 to 30 minutes and is done in the office minor operating room. A laser is used to make the opening through the eardrum over the round window which is like the cornea of the eye. If there are adhesions over the window, they are removed painlessly with a small instrument. The MicroWick is inserted and rests against the round window.

Dexamethasone 4 mg is placed on the wick and a small amount is injected into the middle ear through the eardrum. The patient puts three drops of Dexamethasone drops in the ear three times a day, usually for one month. This ensures that the inner ear receives a constant dosage of steroids throughout the day and for several weeks.

The MicroWick is advantageous as the presence and concentration of the steroids in the inner ear is much higher than when taken orally. The steroids go directly into the  inner ear without affecting the entire body.

In patients with Hypertension, ulcers or diabetes, taking oral steroids may be harmful and so we are able to treat the patient without using the oral steroids.

The results in the literature indicate that the earlier the treatment, the better the result. About 50% will gain some hearing after treatment with the MicroWick and Dexamethasone. Although the results are not as great, we also offer the treatment if the deafness is several months old.