Management of Sudden Onset Sensorineural Hearing Loss and the Role of Pentoxyphylline as an Add-on Therapy to Conventional Treatment

Background/Aims: Sudden Sensorineural Hearing Loss (SSNHL) is a rapid-onset condition with varied etiologies, creating uncertainty in optimal treatment strategies. This study aimed to assess whether adding pentoxifylline to standard antiviral and steroid therapy could enhance hearing recovery in SSNHL patients. Methods: Conducted as a randomized controlled trial from January 2021 to June 2023 in a private clinic within Chennai district, Tamil Nadu, the study enrolled 72 patients aged 20–70 years with SSNHL onset within 7 days. Participants were randomly assigned to receive either standard therapy (antiviral + steroids) or an intervention including pentoxifylline. Baseline assessments and serial pure-tone audiometry (PTA) was done to monitor outcomes. Results: Among the 72 participants, the majority were male (58.3%) with a mean age of 43.4 years, with right-sided hearing loss predominantly. Comorbidities such as diabetes and hypertension were commonly seen among the study population. The intervention group exhibited significantly greater hearing recovery, particularly among those treated within 72 hours of onset. Non-responders underwent MRI brain, identifying CP angle pathology in some cases. Statistical analysis confirmed significantly improved outcomes for the intervention group (p < 0.05). Conclusion: The findings suggest that pentoxifylline, when added to antiviral and steroid therapy, may enhance hearing recovery in SSNHL, especially with prompt treatment. Intratympanic dexamethasone and MRI of the brain are recommended for non-responders to identify underlying pathologies.