Is Corticosteroid Treatment Beneficial in Sudden Sensorineural Hearing Loss? A Large Retrospective Study

Abstract

The main treatment approaches for sudden sensorineural hearing loss (SSNHL) involve oral and intratympanic corticosteroids, but their efficacy remains controversial. The study objective was to evaluate the benefit of oral corticosteroids followed by intratympanic salvage treatment. This was conducted by comparing the hearing results of post-treatment patients arriving early and pretreatment patients arriving late over the same time points after the onset of HL. A cohort of 776 patients with SSNHL was classified into four groups by time from onset of symptoms to the initiation of treatment (weeks). The post-treatment audiometry of those patients presenting during the first and second week post-HL was compared to the pretreatment audiometry of those presenting in weeks three and four. The post-treatment audiometry of week one and pretreatment audiometry of week three was conducted 17.2 ± 4 and 19.4 ± 3 (p = 0.13) days post-HL onset, respectively. The post-treatment audiometry of week two and pretreatment audiometry of week four was conducted on days 24.6 ± 4 and 25.2 ± 3 (p = 0.32). The pure-tune average for week one and three groups was 36.7 ± 28 and 37.5 ± 19 dB (p = 0.55), and for weeks 2 and 4, it was 31.7 ± 22 and 36.6 ± 23 dB (p = 0.1). Similarly, no significant differences in speech recognition threshold and speech discrimination were found. These results question the benefit of corticosteroid treatment for SSNHL and suggest that improvements may be due to the natural healing process.

Keywords

• hearing loss
• corticosteroids
• audiogram
• intratympanic injection
• speech discrimination