Injection technique
The intratympanic injection procedure was performed in an endoscopic ear surgery room. Topical anaesthesia with 1.5% tetracaine was administered for 20 minutes. Patients were placed in a supine position, with their head tilted 40 to 45 degrees toward the side of the healthy ear, and the solution was then perfused into the middle ear after myringotomy. Following injection, the patients were advised to avoid moving their head, speaking or swallowing for 30 minutes.
Treatment protocol
The patients were randomized to groups A(intratympanic dexamethasone) and B (intratympanic plus intravenous dexamethasone). Patients in both groups whose hearing did not recover received the following treatments for 24 days. In group A, dexamethasone was given once every other day for 24 days (5 mg/ml, 1.5 mg/0.3 ml). In group B, intravenous dexamethasone was administered for 12 days (10 mg/d on days 1-4, 7.5 mg/d on days 5-8, and 5 mg/d on days 9-12), and intratympanic dexamethasone was then given once every other day for the following 12 days.