2024 Volume 117 Issue 4 Pages 375-382
Intratympanic steroid therapy (ITS) has recently been used as primary or salvage treatment for idiopathic sudden sensorineural hearing loss.
We conducted a retrospective comparison of the efficacy of ITS and systemic steroid therapy (SS) as initial therapy for idiopathic sudden sensorineural hearing loss (ISSHL).
There were a total of 112 patients who received treatment for ISSHL at our hospital (including 44 who received ITS, and 68 who received SS).
Statistical comparison of the background characteristics of the patients showed that the mean age was significantly higher (76 yr. vs. 65 yr; p < 0.0001), the percentage of patients with diabetes mellitus was higher (55% vs. 18%; p < 0.0001), and the rate of prior steroid use was lower (9% vs. 31%; p = 0.0068) in the ITS group as compared with the SS group. The treatment response at the end of 3 weeks of treatment was complete recovery/significant improvement/slight improvement/no change in 11/9/8/16 patients of the ITS group and 32/11/5/20 patients of the SS group; thus, the SS group showed a significantly higher rate of complete recovery than the ITS group (ITS vs. SS, 25% vs. 47%; p = 0.0191). Analysis after propensity score matching also confirmed a higher rate of complete recovery in the SS group than in the ITS group (ITS vs. SS, 22% vs. 48%; p = 0.0461).
Thus, we recommend SS as a primary treatment for ISSHL in patients who are not elderly and/or not at a high risk for complications from SS.
