title: Comparison of steroid administration methods in patients with idiopathic sudden sensorineural hearing loss: a retrospective observational study.
abstract: OBJECTIVE
  To compare the recovery rates of patients with idiopathic sudden sensorineural hearing loss (ISSHL) treated with oral systemic steroids (PO) or intratympanic steroid injection (IT) or both.
  
  
  METHODS
  A retrospective observational study.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  Eight hundred and forty-four patients diagnosed with ISSHL within 14 days of the onset of symptoms. The patients were divided into three groups by treatment modality.
  
  
  METHODS
  Threshold of pure-tone tests, age, accompanying symptoms and underlying diseases were compared. The level of final hearing recovery was evaluated by the application of the results of the pure-tone test that was performed at least 3 months after the completion of each treatment.
  
  
  RESULTS
  Final hearing recovery rate differed significantly by the type of treatment (P = 0.031). Recovery rates in the PO and combined groups were significantly higher in patients with mild (85.1% and 88.6%, respectively) than with profound (52.8% and 69.0%, respectively) hearing loss (P < 0.05). In contrast, severity and recovery rate were not significantly correlated in the IT group (P > 0.05). Combined treatment yielded significantly higher recovery rates than other treatment modalities in patients without hypertension (HTN) and diabetes mellitus (DM) (P = 0.021).
  
  
  CONCLUSIONS
  In the group treated with combined therapy, better hearing improvement was obtained than in the groups treated with systemic steroid only or with intratympanic steroid injection only without complications. These findings suggest that the combination of systemic administration and intratympanic injection may improve patient prognosis.
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Jung
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
authors.forename: M G
authors.initials: MG
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Byun
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: M S
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: S G
authors.initials: SG
authors.lastname: Yeo
mesh_terms: D000284:Administration, Oral; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006309:Hearing / Q000502:physiology*; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy* / Q000503:physiopathology; D003639:Hearing Loss, Sudden / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone