Outcomes of intratympanic platelet-rich plasma injection in the treatment of sensorineural hearing loss

Background: Sensorineural hearing loss (SNHL) is a common disorder with limited regenerative therapies. Platelet-rich plasma (PRP), rich in growth factors, may promote cochlear repair, though its efficacy remains uncertain.Aim: To evaluate the effectiveness of intratympanic PRP in SNHL and identify predictors of treatment success.Methods: In this uncontrolled prospective trial, 50 patients with SNHL received three intratympanic PRP injections at two-week intervals (September 2022–September 2024, Assiut University Hospital). Autologous PRP was prepared by two-step centrifugation and injected under endoscopic guidance. Outcomes were assessed with pure tone audiometry (PTA), speech discrimination scores (SDS), and modified Siegel criteria. Analyses included repeated measures ANOVA, Chi-square, and logistic regression.Results: Of 50 patients (mean age 35.3 ± 16.2 years; 58% female), 38% showed improvement. Mean PTA thresholds improved from 65.7 ± 9.7 dB to 56.6 ± 11.7 dB (p < 0.001), and SDS from 45.7 ± 5.1% to 61.9 ± 5.3% (p < 0.001). Recovery was highest in moderate SNHL (26–45 dB, 87.5%) and lowest in profound loss (>90 dB, 14.3%). Independent predictors included male sex (OR = 3.729, p = 0.047), shorter disease duration (OR = 0.927/month, p = 0.032), absence of comorbidities (OR = 0.585, p = 0.046), and milder baseline loss (OR = 0.172 for severe/profound, p = 0.012).Conclusion: Intratympanic PRP significantly improved hearing, particularly in moderate SNHL and with early treatment. Reduced efficacy was noted in severe/profound loss and comorbid patients. PRP is a safe, minimally invasive option warranting confirmation in larger controlled trials.