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4. Comparative Efficacy of Systemic VS Intratympanic Corticosteroid Therapy in the Management of Sudden Sensorineural Hearing Loss
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Original Article |
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Systemic VS Intratympanic Corticosteroid Therapy in Hearing Loss |
Comparative Efficacy of Systemic VS Intratympanic Corticosteroid Therapy in the Management of Sudden Sensorineural Hearing Loss
Allah Noor, Muhammad Arif and Hamza Nawaz
ABSTRACT
Objective: To assess the efficacy of systemic versus intratympanic corticosteroid therapy for the treatment of sudden sensorineural hearing loss (SSNHL).
Study Design: This prospective study
Place and Duration of Study: This study was conducted at the ENT Department Hayatabad Medical Complex, Peshawar, from 1-1-2023 to 31-12-2023.
Methods: Total 124 patients with a diagnosis of SSNHL were included in the study; they were separated into 2 therapeutic groups: 72 received systemic corticosteroids, and 52 received intratympanic corticosteroids. The primary outcomes evaluated were hearing recovery rates, improvement in PTA, time to recovery, and adverse effects.
Results: The hearing recovery rate was 67.7%, with complete recovery in 32.3%, partial recovery in 35.5%, and no recovery in 32.3% of patients. The systemic therapy group had significantly superior recovery rates, with 40.3% achieving complete recovery vs. 21.2% in the intratympanic group (p=0.03). Mean PTA improvement was 24.6 ± 9.4 dB in the systemic group and 18.2 ± 8.7 dB in the intratympanic group (p=0.02). Systemic therapy patients also recovered faster (14.8 ± 3.7 days) than the corresponding cohort in the intratympanic group (18.6 ± 4.1 days, p=0.01).
Conclusion: Systemic corticosteroid therapy improved hearing recovery and reduced the time to hearing recovery than intratympanic corticosteroid therapy in patients diagnosed with SSNHL. Intratympanic therapy continues to be a safe and effective option for patients who cannot tolerate systemic treatment.
Key Words: SSNHL, Corticosteroid, Systemic, Intratympanic, Hearing Recovery, PTA.