Hearing Outcomes Differences Between Treatment Modalities in Sudden Sensorineural Hearing Loss

Sunday, September 29, 2024

10:12 AM – 10:18 AM EDT

Location: MBCC, 231

Disclosure(s):

Ana Karen Naranjo:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Karla Rubí Olaya Albor:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Maria Isabel Perez Lopez Burkle, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: In sudden sensorineural hearing loss (SSNHL), several treatment modalities exist. Oral steroids remain the mainstay of treatment, however, no single modality has proven to achieve better results. This study aims to compare audiometric outcomes after treatment with oral steroid monotherapy (OS), oral steroids with synchronous intratympanic injection of dexamethasone (OS&IT), and oral steroids with sequential intratympanic injection of dexamethasone (OS+IT).

Methods: An observational, analytical, and retrospective study was conducted. The electronic files of all patients diagnosed with SSNHL were treated at a tertiary otologic center from October 2017 to January 2023. Patients with a confirmed diagnosis of SSNHL who received treatment with oral steroids or combined with intratympanic injection were included. Hearing outcomes were measured in dB gain in the Pure Tone Average and using Siegel criteria. Statistical analysis was performed using Pearson's Chi-squared test; Kruskal-Wallis rank sum test; Fisher's exact test according to each variable.

Results: A total of 517 charts were reviewed, 93 subjects filled the inclusion criteria, and the main reason for exclusion was a different diagnosis. Median age was 53, and 67% were female. Regarding treatment modalities, 52 patients received OS, 17 received OS&IT, and 24 received OS+IT.

79% of the overall sample had little to no improvement, and there was a significantly higher proportion of Siegel 1 and 2 in the OS group. When evaluating hearing outcomes using the PTA, no difference was found. Receiver operator characteristic curves were designed to find an ideal threshold to start treatment in order to have better outcomes. Starting treatment before 9.5 days from onset was found to be the threshold with an area under the curve of 0.696.

Conclusions: This study found no significant difference in the best regimen for hearing recovery between oral steroid treatment and oral treatment with intratympanic infiltration, regardless of whether they were started together. It was found that there were better results if treatment was started within the first 9 days.

Presenting Author(s)

Ana K. Naranjo

MD
Resident of the Otolaryngology and Head and Neck Surgery Department, Instituto Nacional de Rehabilitación
México, Mexico City, Mexico

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Karla Rubí Olaya Albor

Resident of the Otolaryngology and Head and Neck Surgery Department
Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra"
México City, Mexico City, Mexico

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

MG

Mauricio Gonzalez Navarro

Deputy Director of the Otolaryngology and Head and Neck Surgery Department
National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra
distrito federal, Distrito Federal, Mexico

Disclosure information not submitted.

Co-Author(s)

IS

Ivan Hermann Schobert Capetillo, MD

MD
Instituto Nacional de Rehabilitación, United States

Disclosure information not submitted.
Maria Isabel Perez Lopez Burkle, MD

MD
Instituto Nacional De Rehabilitacion "Luis Guillermo Ibarra Ibarra"
Mexico City, Distrito Federal, Mexico

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
VG

Vervela Garcés Utermann

Resident of the Otolaryngology and Head and Neck Surgery, United States

Disclosure information not submitted.
DM

Daniella Alejandra Monroy Llaguno, MD

MD
Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra
Mexico City, Distrito Federal, United States

Disclosure information not submitted.