Sudden Sensorineural Hearing Loss: Intratympanic Injection Protocol with Dexamethasone

Abstract

Introduction: Sudden sensorineural hearing loss (SSHL) affects thousands of people worldwide, causing disability and reduced quality of life in adults of working age. It is an otologic emergency requiring prompt intervention to prevent permanent hearing loss. Despite various global treatment protocols, no consensus exists regarding the most effective approach. Materials and methods: This descriptive, observational, cross-sectional study included 92 patients diagnosed with SSHL at Hospital Universitario Clínica San Rafael between 2018 and 2022. A protocol of serial intratympanic dexamethasone injections was implemented over three consecutive weeks, within 15 days of symptom onset. A retrospective analysis assessed hearing gain. Results: A polynomial correlation (R² = 0.046) indicated a trend toward greater hearing gains in patients treated earlier. After adjusting the raw data by excluding poor prognosis variables such as advanced age and cardiovascular comorbidities, the trend toward improved outcomes with earlier treatment initiation remained consistent. Discussion: Hearing gain was greater in patients under 65 years old, without comorbidities, and treated earlier. The variability in recovery highlights the influence of multiple prognostic factors and underscores the need for randomized controlled trials to clarify treatment efficacy. Conclusions: SSHL has a variable prognosis influenced by multiple factors. However, patients who receive early intratympanic corticosteroid therapy demonstrate better hearing recovery than those treated later, supporting its role as an effective treatment option in selected cases.