Comparison of Different Treatment Methods for Idiopathic Sudden Sensorineural Hearing Loss

Objective: To evaluate the effectiveness of different therapies for idiopathic sudden sensorineural hearing loss and prognostic factors, and determine the most successful treatment according to the audiogram type and time from onset to treatment. Methods: A total of 90 cases from February 2009 to January 2015 were classified under Group I oral treatment (methylprednisolone, acyclovir, betahistine-dihydrochloride, and vitamin B12); Group II oral treatment + intratympanic steroids (ITS); Group III oral treatment + hyperbaric oxygen; and Group IV only ITS. A pure tone average (PTA) improvement of less than 10 dB was assessed as "noimprovement," a PTA of 10 dB or more or a 10% or more increase in the speech discrimination score (SDS) as "partial improvement," and a hearing threshold within 10 dB and SDS within 5%-10% of the unaffected ear as "full improvement." Results: Overall, 32.2% patients showed full and 28.9% showed partial improvement, whereas 38.9% showed no improvement. There was no significant difference in terms of mean hearing gain between the different treatment methods. As the degree of hearing loss and time from onset to treatment increased, improvement worsened (p<0.05). Descending audiogram had lower mean hearing gains compared to other groups (p=0.014). There was no significant effect of age, sex, tinnitus and/or vertigo, and systemic disease on treatment success (p>0.05). Conclusion: The most important factors affecting prognosis were the time from onset to treatment, hearing loss severity, and audiogram type. Only ITS avoided side effects and reduced hospitalization. ITS in the first two weeks, followed by hyperbaric oxygen were considered as the treatment priority.