Intratympanic Steroid for the Management of Sudden Hearing Loss: Introduction of a Tapering Method

Introduction: sudden sensorineural hearing loss (ssnhl) is a therapeutic challenge. there are several controversies regarding the management protocol of ssnhl. this study aimed to present the results of a novel treatment algorithm, which is a combination of systemic steroids and a tapering intratympanic (it) dexamethasone regimen. materials and methods: the past 10 years’ medical records of idiopathic ssnhl cases in ghaem and emamreza hospital, mashhad university of medical sciences were evaluated. patients were assessed using standardized methods for pure-tone threshold audiometry. the management method of ssnhl treatment included oral steroids combined with it administration of dexamethasone once a day for 7 days and continuing it on an alternate day and then weekly basis. patients’ recovery was assessed using siegel’s criteria. results: this study included a total of 248 cases of idiopathic sudden hearing loss, with a mean age of 40.63±16.19 years. in total, 105 (42.3%) and 143 (57.7%) patients were female and male, respectively. the most common associated symptoms included tinnitus (86.9%, n=205) followed by vertigo (52.1%, n=122). the final hearing outcome of patients showed that 39 (15.7%), 38(15.3%), 86 (34.7%), and 85 (34.3%) patients underwent a complete recovery, partial recovery, slight recovery, and no recovery, based on siegel’s criteria. conclusions: the dose, interval, and duration of it steroid treatment were not universally approved. the treatment method designed based on a tapering of it steroid injection in combination with already known systemic administration of steroids can be a treatment option in ssnhl patients.