الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
• SSNHL is defined as a unilateral or bilateral sensorineural hearing loss of >30decibels (dB) affecting at least three consecutive frequencies, and occurring over a maximum period of 72 h. In the vast majority of patients with SSNHL, no specific cause can be identified, therefore, the disease called “Idiopathic”.
• The recovery rate varies from 31% to 65%, while the hearing recovery in treated patients ranges from 35% to 89%.
• Eighteen (18) patients diagnosed as SSNHL attending outpatient clinic in (AMUH) during the period from 1/7/2015 to 1/7/2016 were treated by direct application of dexamethasone on the round window after its adequate exposure through transcanal approach.
• Under general anesthesia tympanomeatal flap was elevated to visualize the R.W. Gel foam soaked with dexamethasone (4mg/ml) was placed directly over the RW, if RW was hidden by secondary membrane it was removed by curette. Only in cases of profound HL if RW was not fully exposed, the overhanging niche was minimally drilled out first to expose it, and then gel foam soaked with dexamethasone was placed.
• PTA and Speech audiometry were done after two weeks. Hearing recovery was assessed 2 weeks post-operative according to Kim’s criteria.
• We considered that improvement includes (complete recovery, good recovery and fair recovery). While no improvement included (slight recovery and no recovery).
• Seven cases (38.9 %) reported that they became better and their hearing had improved, while eleven cases (61.1%) reported that this procedure did not add to them any benefit and they did not improve.
• In our study we found statistically significant improvement in patients (<40ys) more than those (>40ys), but statistically insignificant improvement between males and females.
• We found statistically significant improvement in patients presented with associated tinnitus with HL more than those presented with associated vertigo.
• The duration of the disease (from its onset to start of treatment) was very important in prognosis; those who came within the first week period of the disease had the best prognosis, while those who came after the fourth week period of the disease had the worst prognosis.
• There was statistically significant improvement in patients presented with ascending (71.4 %) and flat (28.6 %) shape audiograms rather than those with descending and profound shape audiograms.
• The mean hearing threshold pre-operative was 79 dB, it became 68.5dB post- operative. There was gain in the hearing about 10 dB, (this value was statistically significant).
• There was statistically significant improvement among those presented with mild HL (14.3%), moderate HL (57.1%), and moderate to severe HL (28.6%) rather than those presented with severe or profound HL.
• The RW was fully exposed in two cases (11.1 %), it was hidden by a secondary membrane in one case (5.6%), hidden by overhanging niche