Comparative Efficacy of Systemic VS Intratympanic Corticosteroid Therapy in the Management of Sudden Sensorineural Hearing Loss

Abstract

Objective: To assess the efficacy of systemic versus intratympanic corticosteroid therapy for the treatment of  sudden sensorineural hearing loss (SSNHL). 
Study Design: This prospective study  Place and Duration of Study: This study was conducted at the ENT Department Hayatabad Medical Complex,  Peshawar, from 1-1-2023 to 31-12-2023. 
Methods: Total 124 patients with a diagnosis of SSNHL were included in the study; they were separated into 2 therapeutic groups: 72 received systemic corticosteroids, and 52 received intratympanic corticosteroids. The primary outcomes evaluated were hearing recovery rates, improvement in PTA, time to recovery, and adverse effects. 
Results: The hearing recovery rate was 67.7%, with complete recovery in 32.3%, partial recovery in 35.5%, and no recovery in 32.3% of patients. The systemic therapy group had significantly superior recovery rates, with 40.3% achieving complete recovery vs. 21.2% in the intratympanic group (p=0.03). Mean PTA improvement was 24.6 ± 9.4 dB in the systemic group and 18.2 ± 8.7 dB in the intratympanic group (p=0.02). Systemic therapy patients also recovered faster (14.8 ± 3.7 days) than the corresponding cohort in the intratympanic group (18.6 ± 4.1 days, p=0.01). 
Conclusion: Systemic corticosteroid therapy improved hearing recovery and reduced the time to hearing recovery than intratympanic corticosteroid therapy in patients diagnosed with SSNHL. Intratympanic therapy continues to be a safe and effective option for patients who cannot tolerate systemic treatment.