The effect of intratympanic steroid injection frequency in idiopathic sudden sensorineural hearing loss

To evaluate the effect of intratympanic steroid injection frequency on hearing outcomes for patients with idiopathic sudden sensorineural hearing loss.

A retrospective chart review was performed from 2007 to 2015 at a neurotology tertiary referral center. Adults who met academy criteria for idiopathic sudden sensorineural hearing loss within two months of onset and negative imaging were grouped based on injection frequency. Injection schedules were every 1-4 (group 1), 5-10 (group 2), or 11-30 (group 3) days. All patients had at least two injections with Dexamethasone 10 mg/ml. All patients had pre- and post-injection audiograms.

Seventy patients met inclusion criteria (group 1, n = 21; group 2, n = 29; group 3, n = 20). There was no significant difference between group demographics or baseline audiometric data. Mean gains were significant and similar between groups for pure tone average (group 1 = -23.6 ± 22.0 dB; group 2 = -19.7 ± 18.4 dB; group 3 = -24.9 ± 24.7 dB; p = 0.67) and word recognition score (group 1 = +26.3 ± 34.8%; group 2 = +23.3 ± 29.9%; group 3 = +33.4 ± 28.9%; p = 0.53).

Frequency of intratympanic steroid injections does not significantly affect hearing outcomes. Following injection therapy, hearing outcomes improved regardless of prior or concomitant oral steroid regimen. Earlier time to initiating injections yielded a higher rate of hearing improvement. Long term hearing outcomes >6 months did not show significant additional improvement.