Efficacy of Intratympanic Steroid Therapy as a Salvage Treatment for Idiopathic Sudden Sensorineural Hearing Loss

Abstract

Objectives: Recently, comparable therapeutic efficacy of intratympanic steroid injection (IT-S) as a salvage treatment for sudden sensorineural hearing loss (SSNHL) has been reported. We aimed to compare the efficacy of intratympanic steroid injection as salvage treatment, systemic steroid, and intratympanic steroid injection alone. Methods: A retrospective, multicenter study investigating therapeutic efficacies of systemic steroid, intratympanic steroid, and combined therapy as a salvage treatment for SSNHL was designed in 660 patients with idiopathic SSNHL. Patients were divided into three groups according to the therapy they received: Intratympanic steroid injection group (IT-S group), systemic steroid therapy group (SST group) and salvage therapy group (systemic steroid failure + intratympanic steroid, ST group). Hearing was evaluated and more than a 10dBHL decrease was defined as hearing improvement in our study. Results: Among a total number of 660 patients with SSNHL, 94 patients were included in IT-S group, while 444 patients and 122 patients were included in SS and ST group, respectively. Age, gender, time interval from onset to treatment, and initial hearing level of each group were not statistically different. Patients who had concomitant medical disorders such as diabetes mellitus, hypertension and chronic renal failure were more frequently treated with IT-S. There was no significant difference in hearing gain or the ratio of improvement in hearing among three different therapeutic groups of our study. ( P = 0.140, P = 0.450). Conclusions: IT-S as a salvage treatment seemed to be as effective as SS or IT-S alone. We can conclude that IT-S as a salvage therapy is not superior to other monotherapy.