Differences in hearing recovery following intratympanic alone or intravenous dexamethasone with rescue intratympanic steroids for sudden sensorineural hearing loss: A randomised trial.

OBJECTIVES This study aimed to evaluate hearing improvement at different frequencies and the safety of intratympanic (IT) and intravenous (IV) administration of dexamethasone for sudden sensorineural hearing loss (SSNHL). METHODS SSNHL patients were randomly divided into two groups within 72 hours after onset and received 24 days of dexamethasone therapy. Group A received IT dexamethasone once every other day for 24 days. Group B received IV dexamethasone for 12 days, followed by IT dexamethasone once every other day for the following 12 days. Hearing recovery and side effects were compared. RESULTS Subgroup analysis was performed to look for variation in hearing improvement in high frequency, low frequency and overall hearing at different time points. There was no evidence of a difference in hearing outcomes between IT dexamethasone and sequential IV plus IT treatments. Side effects of steroids were observed within 90 days after treatment. The local adverse effects of IT injection were mild. The systemic side effects in group B were more serious than those in group A. CONCLUSIONS IT dexamethasone was safer than IV dexamethasone, and there was no evidence of a difference in hearing outcomes between IT dexamethasone and sequential IV plus IT treatments. It is necessary to make individualised treatment decisions according to the patient's condition.