International Journal of Clinical Science and Medical Research

Background: Sudden sensorineural hearing loss is a medical emergency characterized by sudden sensorineural hearing loss occurring within 72 hours with a hearing threshold decrease of at least 30 dB across three consecutive frequencies. The incidence ranges from 5–150 cases per 100,000 population annually and is likely underestimated because of underreporting. Systemic corticosteroids are currently considered first-line therapy; however, intratympanic corticosteroids are suggested to improve treatment outcomes. 

Objective: To determine the effectiveness of combined systemic and intratympanic corticosteroids compared with systemic corticosteroids alone in patients with sudden sensorineural hearing loss based on pure tone average gain and adverse effects. 

Methods: A systematic review and meta-analysis of randomized controlled trials was conducted using multiple electronic databases. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool and the Scottish Intercollegiate Guidelines Network Methodology Checklist 2. 

Results: Of 1,321 identified studies, four met the inclusion criteria. Meta-analysis demonstrated a mean difference of 8.10 dB (95% confidence interval: 0.61–15.59) with moderate heterogeneity, indicating significant hearing improvement in the combination therapy group. 

Conclusion: Combined systemic and intratympanic corticosteroids provided greater hearing improvement with fewer adverse effects compared with systemic corticosteroids alone in patients with sudden sensorineural hearing loss.

SSNHL, systemic steroids, intratympanic steroids, combination therapy, pure tone average gain

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