Ashtiani MK, et al. - A comparative evaluation was conducted of the rates of recovery from idiopathic sudden deafness after the treatment with oral and intratympanic corticosteroids in both mono and combination therapies. No variation was detected in the rate of hearing improvement between systemic, intratympanic, and combined corticosteroid therapy for sudden hearing loss.

Methods

• The plot of this research was a triple-blind randomized clinical trial.
• It was carried out at a tertiary referral hospital.
• The eligible candidates included 112 patients who were admitted to the ENT emergency department.
• Enrollees were randomly divided into three groups: An oral corticosteroid plus intratympanic placebo (systemic corticosteroid monotherapy group); an intratympanic corticosteroid plus oral placebo group (IT monotherapy group); and a combination therapy group (IT plus systemic combination group).
• Additional treatment with antiviral and proton pomp inhibitor was given to all patients.
• Before beginning the therapies and at the end of the therapy, an audiometry was performed once.

Results

• Herein, 32 patients received intratympanic (IT) corticosteroids, 45 were receiving systemic corticosteroids, and 35 were receiving a combination of the two.
• A posistive response to corticosteroid therapy was reported in 74 subjects (66.1%) [response to treatment was calculated as gain of at least 10 dB in 10 dB in average threshold or with the minimum improvement of 15% in speech discrimination scores (SDS)].
• Findings did not reveal any notable variations between the three groups (IT, systemic group, and combination therapy group) in their overall response to treatment (p=0.5).
• A less positive response to therapy was yielded from patients who suffered from concomitant tinnitus and dizziness (p < 0.002).
• It was determined that positive family history of SSNHL serves as a negative prognostic factor in the response to treatment (p < 0.001).
• Data did not exhibit any link between response to treatment with the pattern (p=0.04) and initial severity of hearing loss (p=0.9).