Retrospective Analysis of Systemic Steroid and Combined Systemic-Intratympanic Steroid Treatment Results and Prognostic Factors in Sudden Idiopathic Hearing Loss

Sudden idiopathic hearing loss (SIHL) is defined as sensorineural hearing loss at 30 dB or more at 3 consecutive frequencies that begins within 72 hours, and the etiology of the disease is still unclear. Steroid treatment is used as systemic and local (intratympanic) in sudden hearing loss, and different results have been reported for both treatment modalities. This study aimed to compare the results of the treatment in patients who received systemic steroid (SS) therapy and in patients who received systemic and intratympanic steroid (ITS) therapy for SIHL. In all, 169 patients who were admitted to our clinic with the diagnosis of SIHL between January 2007 and June 2018 were randomly divided into 2 treatment groups according to their admittance day, such as patients who received only SSs and patients who received SSs and ITSs. The results of these 2 treatment protocols were investigated. Statistical analysis was performed for all patients by grouping many factors that could be effective in prognosis, such as age, sex, and time of initiation of treatment. No differences were found between the SS group and the combined systemic-ITS group in treatment success. It was determined that being under 15 years of age, over 60 years of age, starting treatment after 7 days, vertigo, high initial hearing loss, descendant type, and total loss type in the audiogram configuration are poor prognostic factors. Being between 16 and 59 years of age, starting treatment within 7 days, having no vertigo, mild hearing loss, and having ascendant and plateau type in audiogram configuration are good prognostic factors. We observed that adding ITS treatment to SS treatment as an initial treatment did not provide any extra benefit. However, prospective, randomized, controlled studies will clarify the topic.