Contribution of intratympanic steroids in the primary treatment of sudden hearing loss*

Abstract

Objective: The primary objective is to investigate the contribution of intratympanic steroids in the primary treatment of idiopathic sudden sensorineural hearing loss (ISSNHL). The secondary objective is to compare methylprednisolone (MP) and dexamethasone in terms of their effectiveness and injection-site pain.Methods: Two hundred and four patients with ISSNHL, 144 patients underwent systemic steroid therapy (SST) alone and 60 patients underwent combined therapy (CT). The effectiveness of the treatment was assessed according to the Furuhashi criteria. Injection-site pain after the procedure was assessed at 5 and 60 min on a visual analog scale (VAS).Results: Successful recovery was 55% in the CT group and 34% in the SST alone group (p = .004). Patients whose initial hearing level is severe, the success rate was statistically significantly higher with CT (p = .0001). Hearing improvement differed significantly between the MP and dexamethasone (p = .015). Injection-site pain at 5 min after the procedure, higher VAS scores were obtained with MP (p = .002).Conclusion: In the primary treatment of sudden hearing loss, in which the level of hearing loss is 70–89 dB HL, the addition of ITS to the treatment significantly increased the success rate. The pain occurring in the middle ear was high but tolerable in the first few minutes by MP.