Systemic and intra-tympanic steroids in sudden sensorineural hearing loss: a comparative study

Nada E, Abushab Y, Galhoom D, Abdelsameea A, El-Anwar MW and Abdelmonem S

Published on: 2019-12-30

Abstract

Introduction: Sudden sensorineural hearing loss (SSNHL) is one of the causes for hearing loss (HL). This work aimed to compare the effect of systemic steroids, systemic steroids plus intra-tympanic steroids (ITS) as initial treatment and using ITS injection after failure of systemic corticosteroid for treatment of sudden SNHL.

Materials and Methods: Sixty patients presented to the audiology unit complaining of sudden SNHL of less than 3 days duration. Patients were classified into 3 groups; group I patients were treated using systemic steroids alone, group II was treated by concomitant systemic and ITS and group III that was administered ITS after failure of systemic steroid. Audiological assessment was done before and after treatment.

Results: Significant improvement in pure tone audiometry (PTA) and speech discrimination (SD) was detected in group I and group II (p < 0.00001 at all frequencies). 20 patients received systemic steroid only showed failure of therapy while no patient in group II showed failure of therapy. Significant improvement was detected at frequencies; 250 Hz, 500 Hz, and 4000 Hz after ITS in group III.

Conclusion: Concomitant primary use of ITS with systemic steroid for sudden SNHL significantly avoid therapy failure. Thus it is needed to be investigated on a large number of patients as part of primary treatment of sudden SNHL. Furthermore, after failure of systemic steroids therapy, significant better hearing could be achieved in some frequencies. So we recommend giving ITS even if there is no response with systemic steroid.