Addition of intratympanic steroid or hyperbaric oxygen treatment to systemic steroid treatment in sudden idiopathic sensorineural hearing loss treatment, and long-term results of salvage treatment

Abstract

Background/aim: This study aims to determine the therapeutic superiority of the addition of intratympanic steroid or hyperbaricoxygen therapy to systemic steroid treatment in idiopathic sudden sensorineural hearing loss as initial treatment, and evaluate the longtermresults of salvage treatment.Materials and methods: This study was a retrospective clinical trial with a total of 96 patients with idiopathic sudden sensorineuralhearing loss. Patients were divided into 3 groups. Group 1 (n: 32) received systemic steroid treatment. Group 2 (n: 32) received theGroup 1 protocol plus intratympanic steroid treatment. Group 3 (n: 32) received the Group 1 protocol plus hyperbaric oxygen treatment.Pretreatment and postinitial audiologic evaluations were performed, and the hearing outcome was analyzed with Furuhashi criteria. Allpatients, except those who experienced total recovery after initial treatment, were directed to salvage treatment. Audiologic assessmentwas performed again after salvage treatment and a mean follow-up period of 36.5 months.Results: Each group was homogenous according to demographics, audiologic data, and prognostic factors. There was no statisticallysignificant difference in recovery and success rate within the 3 groups after initial treatment. (P: 0.66, P: 0.248, respectively). Successfulresults were obtained after salvage treatment in only 3 patients (5%). These patients received follow-up treatment at a mean of 36.5months, but there was no spontaneous recovery after the end of salvage treatment.Conclusion: The addition of intratympanic steroids or hyperbaric oxygen to systemic steroids caused no significant hearing improvementas the initial treatment of idiopathic sudden sensorineural hearing loss. The efficacy of salvage treatment was limited, and there was nospontaneous hearing improvement after the long-term follow-up.