Role of transtympanic steroids in idiopathic sudden sensorineural hearing loss

Abstract

Objectives: To determine if the addition of transtympanic steroids to oral steroids improves hearing recovery in idiopathic sudden sensorineural hearing loss (ISSNHL). Methods: Forty adults with unilateral sudden sensorineural hearing loss (defined as a loss of at least 30 dB in 3 contiguous frequencies within 72 hours) and no clinically identifiable etiology were included in this retrospective review. Patients were treated with either oral steroids alone, oral steroids in combination with transtympanic steroid therapy, and transtympanic steroids alone. Treatment with transtympanic steroids alone was restricted to patients with medical contraindications for systemic steroid therapy. In the majority of patients, transtympanic steroids were administered as a single injection of dexamethasone at the time of initial evaluation. Patients in the other 2 treatment groups were self-selected. Pre- and posttreatment audiometric results were compared. Results: Hearing outcomes in the 3 treatment groups were compared within groups and with each other to assess hearing recovery rates with each treatment modality and to determine if there was any benefit of transtympanic steroid therapy in combination with systemic steroids in ISSNHL. Fifty percent or less of patients in the oral only and oral/transtympanic steroid groups experienced partial or complete hearing recovery. Hearing outcomes were not significantly improved with the addition of transtympanic steroids. Conclusions: Our results suggest that the addition of transtympanic steroids, administered as single injections, does not seem to improve hearing outcomes in ISSNHL compared to treatment with systemic steroids alone.