Systemic oral steroids versus intratympanic steroid injection in idiopathic sudden sensorineural hearing loss: a randomized controlled trial

Background Idiopathic sudden sensorineural hearing loss (ISSNHL) is characterized by a rapid decline in hearing that impacts three or more frequencies by a minimum of 30 dB and that persists for three days or less, without any discernible cause. This study aims to compare high-dose intratympanic (IT) dexamethasone versus conventional systemic oral therepy in ISSNHL. Methods This prospective, randomized, controlled trial involved 114 cases diagnosed with unilateral ISSNHL. Cases were randomly allocated into the 2 groups; group A (Systemic oral steroid therapy) and group B (intratympanic high-dose steroid injection). The patients were evaluated for pure tone audiometry (PTA) improvement at one- and six-months post-treatment, speech discrimination score at one- and six-months, tinnitus intensity and incidence of any adverse effects. Results The PTA at 1, 2 and 4 kHz were insignificantly different between both groups. The hearing gain with 1 kHZ was significantly increased in group A (systemic oral steroid therapy) than group B (intratympanic high-dose steroid injectio) ( P < 0.001), and there is an insignificant difference between the two groups in terms of hearing gain at 2 and 4 kHz. The rate of complete recovery was not significantly different between the two groups, despite being higher in group B (IT high-dose steroid injection) (84.21% vs. 75.44%). Conclusions The efficacy of IT steroids was comparable to that of oral steroid therapy in the SSNHL treatment, as both modalities demonstrated significant hearing improvement, as this study confirmed.