Intratympanic depomedrol or oral prednisone. A comparative analysis in idiopathic sudden sensorineural hearing loss (SSNHL).

Abstract

Objective: To compare the efficacy of systemic steroids and intratympanic steroid therapy in terms of hearing outcomes in patients diagnosed with sudden sensorineural hearing loss. Study Design: Prospective Non-randomized Clinical study. Setting: Department of Otorhinolaryngology, Shifa International Hospital, Islamabad. Period: November 2024 to November 2025. Methods: All patients diagnosed with SSNHL were enrolled consecutively and categorized into two groups based on treatment received: oral or intratympanic steroids. All patients were followed. Pre-treatment hearing threshold and post-treatment hearing threshold after completion of treatment and repeat audiogram within 2 months after treatment were assessed. Results: Twenty-nine patients were included (12 oral, 17 intratympanic). There was no significant difference in hearing threshold improvement between oral and intratympanic steroid therapy (Mann–Whitney U = 78.0, p = 0.303), and post-treatment hearing recovery according to Siegel’s criteria was comparable between groups. Multivariable analysis identified longer symptom duration, history of mumps, associated vertigo, and asthma as significant negative predictors of hearing improvement, independent of treatment modality. Conclusion: Oral and intratympanic steroid therapy demonstrated comparable effectiveness in the treatment of idiopathic sudden sensorineural hearing loss. Prognostic factors, particularly delayed presentation and associated vertigo, history of mumps and history of asthma, appear to play a more decisive role in hearing recovery than the route of steroid administration.