Combined Intratympanic and Systemic Steroid Therapy in Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss (SSNHL) is a true otological emergency that must be diagnosed and treated immediately. This study aimed to assess the efficacy of treatment with intratympanic dexamethasone (ITD) plus oral prednisolone with that of oral prednisolone or intratympanic dexamethasone alone and to determine factor affecting treatment outcome for SSNHL. Forty-five patients with SSNHL that had been present within 2 weeks of onset of symptoms were included in this prospective case control study. Patients were allocated to three different groups. Patients in group A were treated with oral prednisolone 1 mg/kg/d full dose 14 days then tapered over next 14 days. Patients in group B were treated with ITD 0.5 ml (4 mg/ml) every 7 days for a total 4 weeks along with oral prednisolone 1 mg/kg/d in tapering dose for 4 weeks. Patients in group C were got ITD 0.5 ml (4 mg/ml) every 7 days for a total 4 weeks. Audiogram was performed before each subsequent injection and at completion of treatment course. Among all participants, 22 patients (48.89%) showed improvement in pure tone audiogram to within 50% of pre- sudden hearing loss. On comparing the results of group A, B and C, there were no statistically significant difference with each other (pvalue 0.185). The mean audiometric gain was 37.71 dB in recovered cases. The combination therapy of intratympanic dexamethasone and oral steroid is more effective in comparison with intratympanic or oral steroid alone in the treatment of SSNHL as the patients benefitted from the therapeutic effects of both local and systemic steroids.