Comparison of Treatment Results According to Mode of Steroid Administration in Idiopathic Sudden Sensorineural Hearing Loss

Objective: To analyze the recovery rates of sudden sensorineural hearing loss (SSNHL) according to steroid treatment regimen and other factors such as severity of initial hearing loss and initial audiogram patterns. Materials and Methods: A retrospective study from January 2005 to March 2010. A total of 854 patients diagnosed with SSNHL within 14 days of the onset of symptoms were included. The patients were divided by 3 treatment modalities (systemic steroid, sequential intratympanic steroid injection after systemic steroid, and intratympanic steroid injection). The threshold of pure tone audiometry and patient characteristics were analyzed. The level of final hearing recovery was evaluated more than 6 months after the completion of each treatment. Results: Overall recovery rates in the systemic steroid group, sequential intratympanic steroid injection after systemic steroid group, and intratympanic injection group were 68.7%, 73.7%, and 59.0%, respectively. Sequential intratympanic steroid injection resulted in significantly higher recovery rate in patients with profound hearing loss when compared with systemic steroid therapy. Sequential intratympanic steroid injection and systemic steroid showed worse recovery rate according to initial severity of hearing loss. Intratympanic steroid injection did not affect recovery rate according to initial severity of hearing loss. Conclusion: Among patients with profound hearing loss at initial exam, sequential intratympanic steroid injection after systemic steroid improved hearing recovery when compared with systemic steroid or with intratympanic steroid injection. Based on these results, we believe that a sequential intratympanic steroid injection after systemic steroid therapy may improve patients' prognoses in the setting of profound hearing loss.