**1. Introduction**

382 Hearing Loss

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The application of drugs through the eardrum and into the middle ear to treat various otologic disorders, such as Meniere's disease and sudden sensorineural hearing loss has recently gained widespread popularity. The intratympanic treatment modality can provide also a chemoprotection strategy for exposure to noise (1) cisplatin (2), and aminoglycosides (3).

Inflammatory processes may play a role in the etiology of various inner ear pathologies of which the pathogenesis is poorly understood. Intratymapanic corticosteroid may be a promising therapy for several ear disorders.

Neurosensorial hearing loss therapy to date has consisted mostly of the systemic administration of steroids and has been limited by their side effects and low therapeutic concentrations within the fluids and tissues of the inner ear. It has been shown in animals and humans that systemically applied glucocorticoids reach only low drug concentrations in the perilymph. The local application of drugs to treat inner ear diseases is expected to provide advantages as compared with systemic treatments, namely: 1) bypassing the bloodlabyrinthine barrier, 2) resulting in higher concentrations in the inner ear fluids 3) avoiding major unwanted effects of systemically administered medications.

Despite some successes, the local medical treatment of inner ear conditions, is often frustrating to patients and physicians. We review the status of the intratympanic corticosteroids treatment.
