Intratympanic methylprednisolone as first-line therapy in sudden sensorineural hearing loss: preliminary results from a case-control series.

BACKGROUND: Sudden sensorineural hearing loss is a true audiological emergency, and its management is much discussed. Currently, no single therapy has been proven effective according to evidence criteria. Recently, intratympanic application of steroids has been increasingly used in refractory cases; however, it has only rarely been reported as first-line therapy. MATERIALS AND METHODS: Twenty consecutive patients with sudden sensorineural hearing loss treated between July 2008 and January 2010 were enrolled in this prospective, case-control study. Ten patients were treated with intratympanic steroids and 10 with systemic 'shotgun' therapy (including steroids, pentoxifylline, low molecular weight heparin and vitamin E). The two groups were homogeneous in all respects. Pure tone averages were assessed before and after treatment for both groups. RESULTS: There were no statistically significant differences between the two groups. CONCLUSION: Intratympanic steroids seem to offer a valid alternative to systemic therapy, with few risks, in sudden sensorineural hearing loss patients, and we recommend their use as first-line therapy.