Sudden sensorineural hearing loss in diabetes mellitus patients receiving intra-tympanic steroid injections

Background

Sudden sensorineural hearing loss is an acute hearing disorder typically managed using steroids. However, prognostic factors of diabetes mellitus (DM) patients undergoing intra-tympanic steroid injections (ITSIs) are unclear. We explored the prognostic factors for ITSI in DM patients with unilateral SSNHL.

Methods

This retrospective study enrolled 89 DM patients with unilateral SSNHL from July 2016 to June 2022. All patients received ITSIs, and their clinical and audiological data were analyzed.

Results

The patients' mean age was 49.31 ± 16.26 years. After ITSI, the mean hearing level gain was 14.91 ± 20.28 dB, the mean speech reception threshold (SRT) gain was 15.78 ± 32.16 dB, and the mean speech discrimination score (SDS) gain was 16.94 ± 35.06 %. Based on Siegel's criteria, 8 patients (8.98 %) had complete recovery, 14 (15.73 %) had partial recovery, 16 (17.98 %) had slight recovery, and 51 (57.31 %) had no improvement. Older age (odds ratio [OR] = 0.970, 95 % confidence interval [CI]: 0.941–0.999, p = 0.043) and profound hearing loss on pure-tone audiometry (PTA; OR = 0.058, 95 % CI: 0.007–0.462, p < 0.001) were adverse prognostic factors in univariate analyses. Older age (OR = 0.963, 95 % CI: 0.932–0.994, p = 0.023) and profound hearing loss (OR = 0.048, 95 % CI: 0.005–0.395, p = 0.004) were independent negative prognostic factors in a multivariate analysis.

Conclusions

ITSI is effective and avoids side effects of high-dose steroids in patients with SSNHL and DM. Among 89 DM SSNHL patients who underwent ITSI, older age and profound hearing loss were negative prognostic factors. Prompt and active management is necessary for DM patients with these risk factors.