Intratympanic steroids as a salvage therapy for severe to profound idiopathic sudden sensorineural hearing loss

Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is defined as a decline in hearing affecting three or more frequencies by 30 dB Objective: The aim of this study was to evaluate the results of intratympanic steroids as a salvage treatment for severe ISSNHL. Materials and methods: A regimen of three IT steroid injections was offered to patients who failed a 7-days intravenous steroid treatment. Eighty-four patients underwent IT salvage treatment (IT group). Their outcomes were compared with those of 255 patients with severe ISSNHL who received the same intravenous steroid regimen without salvage IT steroid therapy (Control group). Results: 56% of the patients in the IT group had a hearing improvement of >15 dB after one month. The average hearing improvements were 26.5 ± 28 dB and 27.9 ± 24 dB in the IT group and the Control group, respectively (p ¼ .67). However, patients with a type E audiogram pattern (total deafness), displayed a substantial hearing gain. Conclusion: Intratympanic steroids failed to show a global auditory benefit as a salvage treatment in patients with severe ISSNHL. Significance: Our data suggest that a salvage treatment with intratympanic dexamethasone may be offered to patients with total deafness for whom the first systemic treatment has failed.