Intratympanic dexamethasone/hyaluronic acid mix as an adjunct to intravenous steroid and vasoactive treatment in patients with severe idiopathic sudden sensorineural hearing loss

Otol Neurotol. 2011 Jul;32(5):756-60. doi: 10.1097/MAO.0b013e31821a3fc3.


Objective: To evaluate differences in effectiveness (hearing recovery rates) between idiopathic sudden sensorineural hearing loss (ISSNHL) patients treated with intravenous therapy alone and patients treated with a combination of intravenous and intratympanic therapy.

Study design: Retrospective case review.

Setting: Tertiary referral hospital center.

Patients and interventions: Ninety-four patients with moderate ISSNHL treated with an intravenous steroid and vasoactive regimen (duration of therapy, 9 ± 2.76 d) and 76 patients with severe ISSNHL treated with a combination regimen of intravenous and intratympanic therapy (duration of therapy, 10 ± 2.71 d) were reviewed. In the latter patients' group, a series of 3 intratympanic injections of a dexamethasone/hyaluronic acid mix solution were applied every 2 days.

Main outcome measure: Pure-tone audiometric thresholds at 0.5, 1, 2, 4, and 8 kHz were compared between groups using the Wilcoxon test.

Results: Combination therapy in severe ISSNHL did not show any statistically significant difference in effectiveness to intravenous therapy in moderate ISSNHL (p > 0.05).

Conclusion: In patients with severe ISSNHL, starting intratympanic steroid therapy as an adjunct early in the course of intravenous steroid and vasoactive therapy improves hearing to a level which is obtained in patients with less severe (moderate) ISSNHL treated with intravenous therapy alone.

MeSH terms

  • Adult
  • Audiometry, Pure-Tone
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use*
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Hearing Loss, Sensorineural / drug therapy*
  • Hearing Loss, Sudden / drug therapy*
  • Humans
  • Hyaluronic Acid / administration & dosage
  • Hyaluronic Acid / therapeutic use*
  • Injections
  • Injections, Intravenous
  • Male
  • Retrospective Studies
  • Steroids / administration & dosage
  • Steroids / therapeutic use*
  • Treatment Outcome
  • Tympanic Membrane


  • Glucocorticoids
  • Steroids
  • Dexamethasone
  • Hyaluronic Acid