Efficacy of Concomitant Intratympanic Steroid Injection for Sudden Deafness According to Initial Hearing Loss

Objectives/Hypothesis: We identified the efficacy and appropriate target group for intratympanic steroid injections (ITS) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design: Retrospective case-control study. Methods: Fifty-five ears treated with concomitant ITS and systemic steroids and 165 ears without ITS treatment were identified. Each case had three controls matched according to the age, sex, and the presence of vertigo. Patients were divided into subgroups according to pure tone audiometric configuration and the levels of initial hearing loss. Hearing results and frequency-related hearing gain were investigated. Results: Additional ITS was effective for patients with an ascending type audiogram or patients with Grade 3 (60-90dB) initial hearing loss. Concomitant ITS, however, resulted in a negative effect on hearing in patients with Grades 1 and 2 (<60dB). ITS resulted in significant (p<0.05) hearing improvement at 250Hz in the Grade 3 (60-90dB) and Grade 4 (>90dB) ITS subgroups. Conclusions: The efficacy of additional ITS for ISSNHL was different among subgroups with various levels of initial hearing loss or audiogram configuration.