Abstract
The frequency of intratympanic (IT) steroid injection varies from once daily to once weekly or less among studies and does not reach a uniform standard. This study investigated the potential association between the number of IT steroid injections and hearing recovery to determine the optimal number in sudden sensorineural hearing loss (SSNHL) patients. A retrospective study involving 233 SSNHL patients receiving IT steroids plus batroxobin within 7 days of onset was performed. Patients were followed up for 3 months. More than 15 dB of HL improvement in the pretreatment pure tone average (PTA) was defined as effective. The effective group had a higher IT injection numbers than the ineffective group (≥ 6 times: 84.6 vs. 61.1, p < 0.001). Regardless of the unadjusted model or adjusted model, patients who received more frequent IT steroid injections seemed more likely to recover hearing (unadjusted model, OR, 95% CI: 1.25, 1.06–1.48; p = 0.007; adjusted model, OR, 95% CI: 1.21, 1.01–1.45; p = 0.044). Six IT injections had the highest rate of hearing recovery (79.1%). In conclusion, IT injection number was an independent factor that was positively associated with hearing recovery, and the optimal number of IT steroid injections was 6. Batroxobin plus higher number of IT steroid injections showed more effective for treating SSNHL.
Highlights
Sudden sensorineural hearing loss (SSNHL) is characterized by hearing loss >30 dB occurring at least 3 consecutive frequencies within 3 days [1]
We found that age, initial treatment time and audiogram shapes were associated with hearing recovery in SSNHL patients, which was consistent with previous studies
By using logistic regression analysis, we found that the number of IT injections could be regarded as an independent factor that was positively associated with hearing recovery, and the optimal number of injections was 6
Summary
Sudden sensorineural hearing loss (SSNHL) is characterized by hearing loss >30 dB occurring at least 3 consecutive frequencies within 3 days [1]. SSNHL affects 5–27 per 100,000 people annually, with approximately 66,000 new cases per year in the United States [2,3,4]. Many treatment options, such as steroids, hyperbaric oxygen therapy, antiviral agents, rheologic agents, and other medications, have been recommended for SSNHL [5]. Steroids are commonly confirmed to be effective and are recommended by the guidelines for SSNHL set by the AAO-HNS in 2019 [1, 6]. Steroids can be given via systemic or intratympanic (IT) therapy.
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