Efficacy of 3 different steroid treatments for sudden sensorineural hearing loss: a prospective, randomized trial

Otolaryngol Head Neck Surg. 2013 Jan;148(1):121-7. doi: 10.1177/0194599812464475. Epub 2012 Oct 16.


Objectives: We treated patients with idiopathic sudden sensorineural hearing loss (ISSNHL) with several protocols on an outpatient department (OPD) basis. The study compared the efficacy of 3 different steroid treatments for ISSNHL.

Study design: A prospective randomized controlled study.

Setting: Tertiary referral center.

Methods: A total of 60 patients diagnosed with ISSNHL were treated through OPD. They were randomly and equally divided into 3 groups based on therapy: oral steroid for 10 days (group I), intratympanic dexamethasone injection (ITDI) 4 times (group II), and both (group III). Pure-tone average (PTA) was measured by taking 4 frequencies (0.5, 1, 2, and 3 kHz). Hearing change was evaluated by comparing pre- and posttreatment PTAs. Recovery rate was assessed by American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Clinical Practice Guidelines.

Results: The hearing gain was 12.8 ± 15.4 decibels (dB) in group I, 12.1 ± 14.6 dB in group II, and 21.9 ± 26.2 dB in group III. The recovery rate was 60% in groups I and III and 55% in group II. The overall recovery rate was 58.3% (35 of 60 patients). There was no significant difference in hearing gain and recovery rates for the 3 groups. Frequency-specific hearing gain also did not differ significantly among groups.

Conclusion: Three different treatment protocols (oral steroid, ITDI, or the combination) resulted in similar hearing recovery rates. Therefore, OPD-based systemic and/or local steroid therapy can be recommended as an initial treatment in ISSNHL.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care / methods
  • Audiometry, Pure-Tone
  • Dexamethasone / administration & dosage*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Hearing Loss, Sensorineural / diagnosis
  • Hearing Loss, Sensorineural / drug therapy*
  • Hearing Loss, Sudden / diagnosis
  • Hearing Loss, Sudden / drug therapy*
  • Humans
  • Injections, Intralesional
  • Male
  • Middle Aged
  • Prednisolone / administration & dosage*
  • Prospective Studies
  • Recovery of Function
  • Reference Values
  • Severity of Illness Index
  • Tertiary Care Centers
  • Treatment Outcome
  • Tympanic Membrane / drug effects
  • Young Adult


  • Dexamethasone
  • Prednisolone