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PRP in
HEARING LOSS

Hearing loss can be a profound disability. Gradual age or noise-related hearing loss is expected, where as sudden onset hearing loss, also known as sudden sensorineural hearing loss or SSNHL, is a devastating 'bolt out of the blue' rendering someone deaf or severely hearing impaired in one ear. SSNHL is defined as a sudden drop of at least 30dB over 3 consecutive sound frequencies within 3 days.

In the Bozeman population, we have seen a 3-4x national average number of cases for reasons unknown.

Time to treatment is as critical to success as is the treatment applied.

Dr. Dodson has witnessed hearing recovery rates at 3x normal with his innovative Tri-Modal SSNHL Therapy involving concomitant oral steroids, intra-tympanic steroids, and hyperbaric oxygen therapy.

To possibly further improve his results, Dr. Dodson offers the addition of intra-tympanic platelet-rich plasma (PRP) infusion to this treatment algorithm- for primary treatment as well as for salvage.

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Sudden Hearing Loss Recovery

CANDIDATES

We recommend any adult with a sudden change in hearing seek immediate evaluation. Hearing change is oft reported as fullness, plugging, 'cotton in the ear' and commonly misdiagnosed as eustachian tube plugging. While immediate hearing screening is ideal, it is not required before initial evaluation. Since time lapsed until treatment is critical (imagine the inner ear having a stroke), quick screening is essential. After 6-8 weeks from hearing loss onset, traditional treatments nearly always fail- at this time point, patients should consider salvage therapy.

PROVEN TREATMENTS, IMPROVED RESULTS

To our knowledge, Dr. Dodson is the first surgeon to combine the time-tested treatments of oral steroids, intratympanic steroids (ITS) and hyperbaric oxygen therapy (HBOT) for sudden sensorineural hearing loss (SSNHL). This Tri-Modal SSNHL Therapy has shown improved hearing recovery rates in our patients. Time is critical - a 6-8 week old SSNHL is rarely recovered even with Tri-Modal SSNHL Therapy. At this time point, alternative salvage treatments, like PRP, can be considered.

PRP IN TREATMENT,
PRP FOR SALVAGE

Emerging research has shown intra-tympanic PRP (ITP) injections may salvage SSNHL treatment failures. It is possible ITP may improve hearing and tinnitus outcomes when used in combination with Tri-Modal SSNHL Therapy. The steps are simple: Blood is drawn, PRP is isolated via centrifugation, then PRP is injected through the ear drum into the middle ear using the hole created from the ITS. For patients who missed the critical 6-8 week treatment window, PRP for Salvage is a reasonable option.

COST

Each ITP injection is $1500. We recommend patients consider at least 2 infusions, 7-10 days apart. There is no established frequency of repeat infusions. We encourage patients seek as many injections as they are comfortable, but all treatment usually ends when hearing is fully recovered or tinnitus has improved to patient satisfaction. ITP is not FDA-approved nor covered by insurance. Unfortunately, the cost of the purification materials and treatment technology prevent any discounts. Please ask to speak to our office manager, Heather, should you require financial assistance.

The Evidence

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Treatment-resistant Sudden Sensorineural Hearing Loss (SSNHL) has limited treatment options, especially as salvage. 56 patients, unresponsive to standard treatments, had PRP injections with an average hearing improvement of ~12 dB, especially at lower frequencies. Some patients had reduced tinnitus. Treatment was well tolerated with no serious side effects.

Intratympanic Platelet-Rich Plasma Therapy for Sudden Sensorineural Hearing Loss: A Preliminary Prospective Study

Indian Journal of Otolaryngology and Head & Neck Surgery (2024) 76:5334–5339

PRP in HEARING LOSS