Idiopathic sudden sensorineural hearing loss (ISSNHL) is commonly defined as a rapid decline in hearing (30 dB or more) involving three or more frequencies for three days or less—without an identifiable cause. ISSNHL reportedly occurs in approximately 12 people per thousand.
Seggas, Koltsidopoulos, Bibas, and colleagues (2011) examined three common protocols to deliver steroids locally to treat ISSNHL. The three common protocols are (1) initial treatment, (2) adjunctive treatment, and (2) salvage treatment. The authors performed a literature review via PubMed and Medline, based on 28 studies (published form 1996 to 2009) meeting their criteria.
The authors (2011) report that, in general, intratympanic steroid therapy seems to be a valuable solution for patients with ISSNHL. Further, when local steroids are used as a "first-line" therapy, they can be as effective as systemic therapies and may offer a reasonable alternative for patients who cannot tolerate systemic therapy. Seggas, Koltsidopoulos, Bibas, and colleagues note that with regard to using combined topical and systemic steroid therapies, the protocol remains controversial and controlled and randomized trials would be beneficial.
For More Information, Recommendations, and References
Dallan I, De Vito A, Fattori B, Casani AP, Panicucci E, Berrettini S, Marchetti M, Nacci, A. (2010) Intratympanic methylprednisolone in refractory sudden hearing loss: a 27-patient case series with univariate and multivariate analysis. Otology & Neurotology 31(1):25-30.
Jourdy DN, Donatelli LA, Victor JD, Selesnick SH. (2010) Assessment of Variation Throughout the Year in the Incidence of Idiopathic Sudden Sensorineural Hearing Loss. Otology & Neurotology 31(1):53-57.
Seggas I, Koltsidopoulos P, Bibas A, Tzonous A, Sismanis A. (2011) Intratympanic Steroid Therapy for Sudden hearing Loss—A Review of the Literature. Otology & Neurotology 32(1).