Efficacy Of Three Corticosteroid Treatment Modalities For The Treatment Of Sudden Sensorineural Hearing Loss

Objective The purpose of present study was to evaluate the efficacy of systemic steroid therapy compared with intratympanic steroid treatment in the patients of Sudden Sensorineural Hearing Loss(SSNHL).Methods Participants were chosen who had unilateral SSNHL referred to the department of otolaryngology of the First Affiliated Hospital of Anhui Medical University between October 2013 and June 2014, 90 patients were randomized divided into three groups were equally(n=30 per group). Group A patients were given oral methyprednisolone tablets, group B patients received intravenous methyprednisolone injection, and group C patients received intratympanic methyprednisolone(MEPD) injection. Pure tone average(PTA) was obtained at pre- and post-treatment as well as one month after.Results In group A, 6 patients experienced complete recovery and 4 a marked recovery, 6 a slight recovery. In Group B, 7 patients reached complete recovery, 2 a marked recovery, 7 a slight recovery. In contrast, 8 patients had a complete recovery, 7 a marked recovery, 6 a slight recovery in Group C. The general effective rate in Group A, Group B, and Group C was 53.3%(16/30), 53.3%, and 70%(21/30), respectively. The mean improvement hearing level were 16.1±15.3 d B, 14.3±12.7 d B, and 21.6±20.4 d B in group A, group B, and group C, respectively. Both the general effective rate and hearing improvement gain were significantly higher in group C than in group A and in group B. While, there was no significant difference between group A and group B with regard to the general effective rate and hearing improvement gain. During the severe hearing loss patients, the hearing improvement was 27.2±23.5 d B in C group higher than 14.4±13.9 d B in B group and 15.1±12.6 d B in C group. No media otitis and residual tympanic membrane perforations were observed in any of the individuals at their last visit and we did not find any case who’s hearing loss worsened during the treatment.Conclusions Local injection by intratympanic was better than systemic administration from present study in the treatment of SSNHL and we recommend to use ITIS for the initial SSNHL especially for patients who has limitation to use steroid systemically and severe hearing loss.