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

C Schmit; F Keller; T Gottfried; M Santer; A Tröger; M Kloppenburg; J Klarer; A Stenzl; J Schmutzhard; B Hofauer; D Dejaco

doi:10.1007/s00405-025-09432-7

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

Eur Arch Otorhinolaryngol. 2025 May 20. doi: 10.1007/s00405-025-09432-7. Online ahead of print.

Authors

C Schmit¹, F Keller², T Gottfried³, M Santer¹, A Tröger¹, M Kloppenburg¹, J Klarer¹, A Stenzl¹, J Schmutzhard¹, B Hofauer¹, D Dejaco¹

Affiliations

¹ Universitätsklinik Für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, A-6020, Innsbruck, Österreich.
² Univ.-Klinik Für Innere Medizin IV (Nephrologie Und Hypertensiologie), Medizinische Universität Innsbruck, Innsbruck, Austria.
³ Universitätsklinik Für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, A-6020, Innsbruck, Österreich. Timo.Gottfried@i-med.ac.at.

PMID: 40394254
DOI: 10.1007/s00405-025-09432-7

Abstract

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.

Keywords: CO2-laser; Hearing outcomes; Intratympanic glucocorticoid injection; Sudden hearing loss.