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Received May 25, 2019 Revised September 17, 2019 Accepted September 20, 2019 Address for correspondence Il-Woo Lee, MD, PhD Department of OtorhinolaryngologyHead and Neck Surgery, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea Tel +82-55-360-2651 Fax +82-55-360-2162 E-mail entgate@pusan.ac.kr Background and Objectives The combined intratympanic and oral steroid treatment has been accepted as effective treatment strategy for idiopathic sudden sensorineural hearing loss (ISSNHL). However, the treatment protocol of combined treatment for ISSNHL has not been established. In this study, we investigated whether hearing outcome differed according to different starting timing of intratympanic steroid injection (ITSI) in combined treatment for ISSNHL. Subjects and Method Tertiary academic referral center-based retrospective medical records of idiopathic 144 ISSNHL patients who received combined treatment from January 2015 to April 2018 were reviewed. All patients underwent a 2-week oral systemic steroid treatment and multiple ITSI. The hearing results of 3 months after treatment were compared according to the timing of ITSI. Results The mean pure tone audiogram gain was 24.3±23.6 dB. When Siegel’s criteria was applied, the overall rate of hearing improvement was 63.9% (92/144). The rate of hearing improvement was significantly higher in women (p=0.043) statistically, and there was a statistically significant lower rate of recovery in the former history of hearing loss (p<0.01) or otitis media (p<0.01). Moreover, the shorter the delay between symptom onset and initial ITSI, greater the statistical significance of hearing recovery rate became (p<0.01). Conclusion The result of this study suggests that early ITSI during combined intratympanic and oral steroid treatment increases the chance of hearing recovery. Korean J Otorhinolaryngol-Head Neck Surg 2020;63(10):448-57

korean journal of otorhinolaryngology-head and neck surgery

Hearing Outcome According to the Intratympanic Steroid Injection Starting Timing in Combined Intratympanic and Oral Steroid Treatment for Idiopathic Sudden Sensorineural Hearing Loss