Introduction
Sudden sensorineural hearing loss (SSNHL) affects approximately 5 to 27 per 100,000 people annually in the United States, similar to the case frequency in other countries, and this incidence has been increasing gradually [1-3]. Corticosteroids alone or combined with hyperbaric oxygen therapy have been shown to be effective and are widely utilized by otologists. However, the range of therapeutic strategies remains various because of the uncertain comparative efficacy and safety of competing treatments. A recent systematic review and network meta-analysis of existing pharmaceuticals included a large number of studies involving patients who received intratympanic, intravenous plus+intratympanic, and oral steroids treatment. Although the results were unclear due to the high risk of bias, they rated intratympanic plus systemic steroid treatment as the best of the six included interventions[1]. However, in other studies, intratympanic steroids (ITSs) led to better outcomes, including PTA improvement and a better recovery rate, than intravenous steroid treatment [2]. This study evaluated the efficacy and side effects of initial ITSs and intravenous plus intratympanic steroids, which were administered over a longer course than that used incommon practice for patients diagnosed with SSNHL.
Patients and methods