AUTHOR=Mariani Cinzia , Carta Filippo , Catani Giulia , Lobina Sara , Marrosu Valeria , Corrias Simone , Tatti Melania , Puxeddu Roberto 

TITLE=Idiopathic sudden sensorineural hearing loss: effectiveness of salvage treatment with intratympanic dexamethasone or hyperbaric oxygen therapy in addition to systemic steroids

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1225206

DOI=10.3389/fneur.2023.1225206

ISSN=1664-2295

ABSTRACT=Background: The development of standardized treatments for idiopathic sudden sensorineural hearing loss (ISSNHL) is hampered by uncertainty over the etiology of this disorder. Systemic steroids are historically the primary therapy, with variable hearing outcomes. Over the last two decades, intratympanic steroids (ITS) and hyperbaric oxygen therapy (HBOT) have been proposed as salvage treatments in case of failure of systemic steroids. The present study aims to evaluate the effectiveness of these salvage treatments in addition to systemic steroids.Methods: We performed a retrospective study on 75 consecutive patients with diagnosis of ISSNHL who were admitted at the Department of Otorhinolaryngology of our hospital between December 2018 and December 2022. All patients received a primary treatment with systemic steroids. In case of slight or no hearing recovery within the fifth day from the beginning of the therapy (T1), a salvage treatment with ITS or HBOT was proposed. Patients were divided into three groups according to the therapy received: systemic steroids (group A), systemic steroids + HBOT (group B), systemic steroids + ITS (group C). Pure-tone average at 500, 1000, 2000 and 3000 Hz, and the mean gain were evaluated at T1 and 3 months after the beginning of the salvage treatment (T2). The hearing recovery was assessed according to Siegel criteria.Results: Sixty-two patients (31 males, 31 females, mean age 56 years) with failure of the primary treatment were definitively enrolled in the study: 34 (54.8%) in the group A, 16 (25.8%) in the group B and 12 (19.4%) in the group C. The ratio of patients responding to therapy was higher in the group A (29.4%) compared with groups B (18.75%) and C (16.7%). We did not find any statistically