Comparison of Hearing Outcomes of Systemic Steroid Monotherapy and Intratympanic Steroid Combined Treatment in Idiopathic Sudden Sensorineural Hearing Loss

Abstract

Background and Objectives Steroid treatment is used as a main treatment modality for sudden sensorineural hearing loss (SSNHL). Intratympanic injection of steroid (ITS) has been used and its therapeutic efficacy reported as being comparable to the systemic steroid administration (SS). This study compares the hearing outcomes of using ITS and SS simultaneously and SS alone.Subjects and Method Retrospective chart review was performed for 146 patients with SSNHL. The patients were divided into 2 groups according to the method of treatment (SS and ITS simultaneously vs. SS alone). The inclusion criteria were starting treatment within 7 days after onset, and follow up pure tone audiometry at least 4 weeks after treatment. Hearing gain for pure tone threshold of each frequency and average of 4 frequencies (500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz) were compared between both groups.Results The improvement in PTA at 1-month follow-up was 27.3±20.0 dB HL in the simultaneous group and 19.1±19.5 dB HL in the SS alone group; this was not statistically significant. Complete or partial recovery at 1-month follow-up was observed in 65.3% of the simultaneous group and 69.6% of the SS alone group; this was also not significant.Conclusion There was no significant difference in hearing outcomes between the simultaneous and SS alone group. The simultaneous therapy does not appear to be superior to the SS alone therapy. Further studies using more population and longer follow-up periods are necessary.

Postauricular versus systemic use of steroids for sudden hearing loss: A systematic review and meta-analysis of randomized controlled trials

“…Of the 258 potentially eligible studies, 220 articles were excluded for the following reasons: the study was not an RCT and/or the lack of a suitable comparator. Ultimately, 38 studies [7–44] with 3609 participants were included. All the studies were published in Chinese from 2013 to 2021.…”

“…Since then, an increasing number of clinicians have started to use postauricular steroid injection as a treatment for SSNHL, and the treatment was also included and recommended in the guidelines for SSNHL in China. [7–44,52] Nevertheless, the efficacy of postauricular injection is still controversial.…”

“…[10,13,31] In terms of incomplete outcome data, 16 studies completely described the treatment efficacy and side effect conditions. [7,9,13,16,17,22,[24][25][26]32,33,35,[37][38][39]42] In the domain of selective reporting and other bias, all the studies were judged as having a "low" risk of bias (Fig. 3A and B).…”

“…Sixteen of the 38 studies reported adverse reactions [7,9,13,16,17,22,[24][25][26]32,33,35,[37][38][39]42] (Fig. 5A).…”

Pregnant Patients with Sudden Sensorineural Hearing Loss: Treatments and Efficacy

“…It was based on a meta-analysis and an observational study. 8 , 9 These steroids include methylprednisolone, prednisolone, solumedrol, and dexamethasone, which can be administered via oral, intravenous, and intratympanic injection or postauricular injection. In this study, methylprednisolone was administered by tympanic injection, while prednisone was administered orally.…”