Abstract
We studied the efficacy of intratympanic steroid treatment on idiopathic sudden sensorineural hearing loss (ISSNHL) in comparison with hyperbaric oxygen therapy (HBO). Two hundred and forty consecutive patients with ISSNHL (initial hearing level ≥ 40 dB, time from onset to the start of treatment ≤ 30 days) were enrolled. In addition to systemic steroid administration to all patients, 174 underwent HBO (HBO group) and 66 received the intratympanic dexamethasone injection (IT group). Hearing outcomes were evaluated by 6 indices; the cure rate, marked-recovery rate, and recovery rate according to the criteria of the Ad Hoc Committee of the Japanese Ministry of Health, Labor and Welfare, and the hearing improvement rate, hearing level after treatment, and hearing gain. The overall recovery rate was significantly higher in the IT group than in the HBO group (81.8% vs. 68.4%, p = 0.039), which was confirmed by multiple logistic regression analysis (odds ratio = 2.184; 95% confidence interval, 1.015-4.701; p = 0.046). The recovery rate in the patients without vertigo and that in the patients treated within 7 days from onset were also higher in the IT group than in the HBO group (87.8% vs. 72.4%, p = 0.043; 87.0% vs. 72.7%, p = 0.036). These results indicate that the intratympanic steroid treatment is more effective than HBO on ISSNHL.
