Retrospective analysis of different application methods in intratympanic glucocorticoid therapy for treatment of idiopathic SSNHL: A comparative outcome study.

Purpose: Glucocorticoids for sudden sensorineural hearing loss (SSNHL) can be administered systemically or via intratympanic injection. This study evaluates the impact of different intratympanic injection techniques on patient outcomes.

Methods: A retrospective analysis was conducted on patients diagnosed with idiopathic SSNHL (January 2008-May 2023). Patients were grouped by application technique: (1) transtympanic injection under local anesthesia (TI), (2) CO₂ laser paracentesis under general anesthesia (LP), and (3) VT application under general anesthesia (VT). Primary outcomes included hearing improvement and tympanic membrane perforation closure time.

Results: The study included 99 patients: 28 with TI, 34 with VT, and 37 with LP. Groups showed no significant differences in sex, affected side, therapy initiation interval, pretreatment type, preoperative BCPTA4, subjective improvement, or treatment-related pain (all p > 0.1). Hearing thresholds improved significantly in the LP and VT groups with large (d = 0.832, p < 0.001) and medium (d = 0.513, p = 0.01) effect sizes, respectively, but not in the TI group (d = 0.294, p = 0.137). Tympanic membrane closure time differed significantly among groups (p < 0.001).

Conclusions: LP and VT significantly improved hearing thresholds in SSNHL patients. LP demonstrated the highest efficacy, consistent results across SSNHL severities, and the fastest tympanic membrane closure, making it the preferred method.