Intratympanic steroid injection for inner ear disease

Many inner ear diseases are not adequately treated by systemic delivery of medication. The blood–cochlear barrier limits the concentration and size of molecules that leave the circulation and access the inner ear. This paper reviews the updated status of intratympanic steroid injections (ITS) for the treatment of inner ear disease. ITS is a nonaggressive procedure in which high concentrations of medication reach the cochlea and systemic side effects are minimized. In addition, this procedure is effective for cochleovestibular symptoms caused by various inner ear diseases including noise-induced hearing loss, idiopathic sudden sensorineural hearing loss, Ménière's disease, and autoimmune inner ear disease. Although the effect of ITS on noise-induced hearing loss is inconclusive, there is a possibility that its indications could be extended, with a new horizon for pharmacological, neurotrophin, gene, and cell-based therapy.