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WHAT ARE CORTICOSTEROIDS?

Corticosteroids are man-made drugs that work like cortisol, a natural steroid hormone in
your body.
These medicines reduce inflammation and alter the immune system.
They’re used to treat a variety of medical conditions.
They can be taken as tablets or injected into the bloodstream or body tissues.

WHAT ENT CONDITIONS MAY REQUIRE A COURSE OF ORAL CORTICOSTEROIDS?

Sensorineural hearing loss
Oral Corticosteroids:
In sudden sensorineural hearing loss, the use of high dose oral corticosteroids within the first 2 weeks provides about 15-30% additional chance of some hearing recovery.
The medication does not guarantee recovery but has been proven to help.
Alternatives include no treatment with at least 30% of patients recovering spontaneously.
Intratympanic Corticosteroids:
Another option is semi-experimental treatment, currently recommended for those who cannot take oral systemic steroids or fail to respond to oral corticosteroids, including injection of steroid via the ear drum. This can be done under local anesthetic.
Evidence suggests some effectiveness with the injection.
Injection of Dexamethasone via the ear drum has a risk of dizziness, infection and eardrum perforation. The treatment may need to be repeated several times.

Rhino-sinusitis exacerbation
Corticosteroids have a proven benefit in improving symptoms of sinusitis in acute and chronic settings.
It is not recommended to stay on oral corticosteroid long- term for sinusitis due to side effects. However, short term treatment 2-3 times per year is acceptable for most.
Long- term intra-nasal steroids are safe due to negligible absorption into the bloodstream.

Peri-operative treatment for sinus surgery
A short course of oral corticosteroid before the operation has been proven to reduce the degree of bleeding during sinus surgery in certain conditions (chronic sinusitis with nasal polyps), which is likely to be translated into safer surgery.
After the operation, this anti- inflammatory medication helps to reduce the load of inflammation.

Acute Vertigo
A short course of oral corticosteroid is effective in reducing the symptom of dizziness in the acute setting from many causes.
Whether it may decrease progression and worsening of the dizziness is unclear but possible.

Acute Dysphonia due to Inflammatory conditions of the Vocal Folds
A short course of oral corticosteroid is sometimes used in inflammatory conditions of the vocal folds, when there is an important pending vocal commitment.
It can reduce the stiffness and bulk of the vocal fold and thus the effort required to produce a sound.

WHAT ARE THE CONTRAINDICATIONS TO CORTICOSTEROID USE?

As with most medications, certain co-existing conditions or medications may contraindicate the use of corticosteroids in your case.
Please review carefully the list of contraindications below. If you have any of the conditions below, please discuss it with your doctor.
Diabetes Mellitus
Current infection
Poorly controlled blood pressure
Mental health issues – depression, anxiety, bipolar disorder, suicidal attempts, schizophrenia and others
Advanced age (over 70 yr)
Dementias
Glaucoma
Cataracts
Peptic ulcer disease, gastritis, severe reflux
Arthritis
Liver disease, excessive alcohol consumption
Sometimes, Corticosteroids can still be taken with special precautions even if you have one of
the above conditions

WHAT ARE THE CORTICOSTEROIDS SIDE EFFECTS FROM SHORT-TERM ORAL USE?

As with most medications, there are certain potential side effects associated with the use of Corticosteroids, Ask our ENT specialist at Tarabichi ENT.
Most side effects are due to long term use, i.e. > 1 month, but short-term side effects are also possible
Side effects that can occur due to short term use are listed below:
Insomnia
Increased appetite
Exacerbation of mental health issues such as depression
Delirium and confusion – most likely in older patients or people with dementia
Increased stomach acid secretion and stomach ulcer disease
Worsening of diabetes mellitus control
Worsening of Blood pressure
Worsening of a current infection
Acute glaucoma
Worsening of cataracts
Avascular necrosis (AVN) of a joint especially hip or shoulder.
Very rare complications occurring in less than 1 in 300 patients.
May cause arthritis long term.
More common in people with liver disease and excessive alcohol consumption.
Stop the medication immediately if you experience sudden joint pain and see your GP or MEG Specialist.

HOW DO I TAKE ORAL CORTICOSTEROIDS?

Doses will be prescribed by the doctor.
If you are taking the medication for more than 1 week, you may be prescribed a tapering dose – it is important to follow this regimen.
Take the medication with food or immediately after food.
Take the medication in the morning or no later than lunch to reduce the risk of insomnia.
Prepare healthy snacks in case of increased appetite.
Ideally, have someone around you when you take the first 2 doses in case you develop an allergy or mental health issue exacerbation, or severe mood swings.

CONCERNS OR QUESTIONS?

To know more, Reach out to the Best ENT doctors in Dubai here at Tarabichi Healthcare. Our team will connect you with the Best Ent Specialist in Dubai. for more details.
Call +971 44 131 000