Intratympanic steroids versus oral steroids in idiopathic sudden sensorineural hearing loss, hospital-based study


  • Arshed Alil Department of Otorhinolaryngology, Government Medical College/Hospital, Srinagar, India
  • Omar Mohammad Shafi Department of Otorhinolaryngology, Government Medical College/Hospital, Srinagar, India
  • Farah Deeba Department of Otorhinolaryngology, Government Medical College/Hospital, Srinagar, India



ISSHL, Intra tympanic steroids, Pure tune audiogram


Introduction: Idiopathic sudden sensorineural hearing loss (ISSHL) is defined as a hearing loss of 30 dB or more, affecting at least 3 consecutive frequencies, occurring within 3 days without any identifiable cause. To find the effectiveness of intratympanic steroid injection (ITS) for hearing recovery and comparing the results with oral steroids therapy. 

Materials and Methods: This prospective study was done in the department of ENT, Govt medical college, Srinagar, over a period of two years. A total 60 patients of ISSHL was selected for the study. Through examination, otoscopy and pure tone audiometry (PTA) was done for all the cases before initiation of therapy. Thirty patients received and thirty patients received oral prednisolone for a protocol-based dose and duration. PTA was repeated every two weeks over duration of two months for documentation of improvement of hearing on pure tone four frequency averages.

Results: Chances of recovery were more with middle ear injection group in 18 patients (60%) in comparison to oral steroids in 14 patients (46.66%). Complete recovery was found in six cases (20%) in injection group and four cases (13.33%) in oral steroid group. The ITS group showed a better control of associated symptoms like dizziness, tinnitus and vertigo are controlled better with ITS (73.33%) than oral steroid group (56.66%). The ITS group showed faster recovery also with lower side effects.

Conclusion: Intratympanic dexamethasone injection is more effective in comparison to oral prednisolone for the management of ISSHL, however larger studies may be required.


Kleyn AD. Sudden complete or partial loss of function of the octavus system in apparently normal persons. Acta Otolaryngologica. 1944;32:407-429.

Byl FM. Sudden hearing loss: eight years’ experience and suggested prognostic table. Laryngoscope. 1984;94(5):647-661.

Mattox DE and Lyles CA. Idiopathic sudden sensorineural hearing loss. American Journal of Otology. 1989;10(3)242-247.

Wilson WR. The relationship of the herpesvirus family to sudden hearing loss: a prospective clinical study and literature review. Laryngoscope. 1986;96(8)870-877.

Schuknecht HF and Donovan ED. The pathology of idiopathic sudden sensorineural hearing loss. Archives of Oto- Rhino-Laryngology. 1986;243(1)1-15.

Ciuffetti G, Scardazza A, Serafini G, Lombardini R, Mannarino E, and Simoncelli C. Whole-blood filterability in sudden deafness. Laryngoscope. 1991;101(1)65-67.

Byl FM. Seventy-six cases of presumed sudden hearing loss occurring in 1973: prognosis and incidence. Laryngoscope. 1987;5(1):817-825.

Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol. 1977;86(4): 463- 480.

Parnes LS, Sun AH, Freeman DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope. 1999;109:1-17.

Chandrasekhar SS, Rubinstein RY, Kwartler JA, Gatz M, Connelly PE, Huang E, et al. Dexamethasone pharmacokinetics in the inner ear: comparison of route of administration and use of facilitating agents. Otolaryngol Head Neck Surg. 2000;122:521-8.

Wilson WR et al. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double blinded-blinded clinical study. Archives of Otolaryngology. 1980;106:772-6.

Eisenman DJ, Alexander A. Effectiveness of treatment for sudden sensorineural hearing loss. Arch Otolaryngol Head Neck Surg. 2000;126(9):1161-1164.

Gulya AJ. Sudden sensorineural hearing loss: an otologic emergency. Compr Ther. 1996;22(4):217-221.

Kronenberg J, Almagor M, Bendet E, Kushnir D. Vasoactive therapy versus placebo in the treatment of sudden hearing loss: a double-blind clinical study. Laryngoscope. 1992;102(1):65-68.

Barton MJ and Harvey RJ. Idiopathic sudden sensorineural hearing loss. In: Michel Gleeson, editors. Scott- Brown’s. Otolaryngology Head and Neck Surgery. 7th edition. Hodder-Arnold. 2008;3577-3590.

Mukherjee M, Sugihara D, Mohanti M. The effect of intratympanic steroid injection frequency in idiopathic sudden sensorineural hearing loss. Am J Otolryngol. 2018;39(6):688-692.

Sutton L. Intratympanic steroid use for idiopathic sudden sensorineural hearing loss: current otolaryngology practice in Germany and Austria. Eur Arch otorhinolaryngol.2018; 275(5):1103-1110.






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