Abstract
Background/aim This study aims to determine the therapeutic superiority of the addition of intratympanic steroid or hyperbaric oxygen therapy to systemic steroid treatment in idiopathic sudden sensorineural hearing loss as initial treatment, and evaluate the long-term results of salvage treatment. Materials and methods This study was a retrospective clinical trial with a total of 96 patients with idiopathic sudden sensorineural hearing loss. Patients were divided into 3 groups. Group 1 (n: 32) received systemic steroid treatment. Group 2 (n: 32) received the Group 1 protocol plus intratympanic steroid treatment. Group 3 (n: 32) received the Group 1 protocol plus hyperbaric oxygen treatment. Pretreatment and postinitial audiologic evaluations were performed, and the hearing outcome was analyzed with Furuhashi criteria. All patients, except those who experienced total recovery after initial treatment, were directed to salvage treatment. Audiologic assessment was performed again after salvage treatment and a mean follow-up period of 36.5 months. Results Each group was homogenous according to demographics, audiologic data, and prognostic factors. There was no statistically significant difference in recovery and success rate within the 3 groups after initial treatment. (P: 0.66, P: 0.248, respectively). Successful results were obtained after salvage treatment in only 3 patients (5%). These patients received follow-up treatment at a mean of 36.5 months, but there was no spontaneous recovery after the end of salvage treatment. Conclusion The addition of intratympanic steroids or hyperbaric oxygen to systemic steroids caused no significant hearing improvement as the initial treatment of idiopathic sudden sensorineural hearing loss. The efficacy of salvage treatment was limited, and there was no spontaneous hearing improvement after the long-term follow-up.
Highlights
Idiopathic sudden sensorineural hearing loss (ISSHL) is an infrequent otologic emergency which is defined as loss of more than 30 dB in at least 3 contagious frequencies within 3 days
Background/aim: This study aims to determine the therapeutic superiority of the addition of intratympanic steroid or hyperbaric oxygen therapy to systemic steroid treatment in idiopathic sudden sensorineural hearing loss as initial treatment, and evaluate the longterm results of salvage treatment
Successful results were obtained after salvage treatment in only 3 patients (5%)
Summary
Idiopathic sudden sensorineural hearing loss (ISSHL) is an infrequent otologic emergency which is defined as loss of more than 30 dB in at least 3 contagious frequencies within 3 days. Gau and Liu performed a metaanalysis with 8 studies about the addition of ITS to SS [12]. They reported better outcomes in pure tone threshold average (PTTA) scores, in severe-profound hearing loss patients, with the addition of ITS. There are 2 systematic reviews in the literature that were performed with 19 and 16 trials of the addition of HBOT to SS. Both of them recommended the addition of HBOT to SS, especially in severe-profound hearing loss [13,14]
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