Therapy of idiopathic sudden sensorineural hearing loss with intratympanic steroid injection.

Objective: To evaluate the efficacy of intratympanic steroid injection in patients with idiopathic sudden sensorineural hearing loss (SSNHL) who are not responding to systemic steroids.

Methods: A prospective cohort study of 31 patients, with idiopathic SSNHL refractory to oral steroid therapy, who were treated with intratympanic steroid injection. The injections were performed once a week for three consecutive weeks. Pure tone audiometry (PTA) and speech discrimination score (SDS) was performed before and two months after intratympanic steroid injection had been completed. Successful treatment was defined as a decrease in PTA by 10 dB or more, or an increase in SDS by 20% or more.

Results: Thirty-one patients were treated with intratympanic steroid injection, 22 women and 9 men. The average age was 53 years. Overall success was 14 patients (45.2%). Eleven of the patients (35.5%) showed either improvement in PTA or SDS, among these there were two patients who had improvement in only PTA and nine patients had improvement only in SDS. Besides, three of the patients (9.7%) had improvement in both PTA and SDS.

Conclusions: Intratympanic steroid injection effectively improves hearing in patients with SSNHL after treatment failure with oral systemic steroid and is not associated with side effects. Therefore, it can be used as salvage therapy after failed conventional treatment. Further studies are required to consider whether intratympanic steroid injection might be used as the first line treatment in SSNHL.