Potential Complications Associated with Steroid Use in the Middle and Inner Ear‪.‬

Glucocorticoids have been used to treat disorders such as sudden sensorineural hearing loss, autoimmune hearing loss, Meniere's disease, and hearing loss secondary to trauma, viral insult, and idiopathic causes. When used to treat disorders of the inner ear, steroids have traditionally been administered systemically. However, it has been postulated that the steroid levels achieved in the inner ear with systemic administration are not consistent because of the presence of the blood-labyrinth barrier. (1) This can lead to potentially suboptimal therapeutic concentrations and subsequent treatment failure. Another concern with the systemic administration of steroids is the side effects associated with this route. Possible complications include fluid and electrolyte imbalance, muscle weakness and a loss of muscle mass, tendon rupture, osteoporosis, vertebral fractures, aseptic necrosis of the humeral and femoral heads, peptic ulcer, impaired wound healing, a cushingoid state, adrenocortical insufficiency, cataracts, and decreased carbohydrate tolerance.