Response to Intratympanic and Oral Steroids in Idiopathic Sudden Sensorineural Hearing Loss

Saturday, October 17, 2026

10:00 AM - 10:06 AM PT

Location: West Exhibit Hall A, Learning Zone 1

Presenting Author(s)

KW

Kennedy L. Williams, n/a

Medical Student (MS2)
UT Southwestern Medical Center
Dallas, Texas, United States

Co-Author(s)

EW

Emily C. Wong, MD

Fellow Physician
UT Southwestern, United States
RF

Rance J.T Fujiwara, MD MBA

Assistant Professor
UT Southwestern Medical Center
Dallas, Texas, United States
HS

Hitomi Sakano, MD

Assistant Professor
UT Southwestern Med Ctr
Dallas, Texas, United States
BI

Brandon Isaacson, MD

Professor
UT Southwestern Medical Center
DALLAS, Texas, United States
JK

Joe W. Kutz, Jr., MD

Professor of Otolaryngology and Neurological Surgery
The University of Texas Southwestern Medical Center
Dallas, TX, United States

Senior Author(s)

Daniel E. Killeen, MD

Assistant Professor
UT SOUTHWESTERN
Dallas, TX, United States

Disclosure(s):

Joe W. Kutz, MD, Jr.:

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

Daniel E. Killeen, MD:

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

Introduction: Prompt treatment with steroids, either oral (PO) or intratympanic (IT), improves hearing recovery in Idiopathic Sudden Sensorineural Hearing Loss (SSNHL). The aim of this study was to investigate hearing outcomes in those treated with different steroid regimens.

Methods: Retrospective single tertiary care center study of patients with unilateral SSNHL(30 dB drop in 3 frequencies) from 2015-2025. Demographic, audiometric data, and treatment (PO, IT, upfront combined PO and IT steroids, or upfront PO with salvage IT steroids) were all collected with outcome measure of pure tone average (PTA) or word recognition score (WRS). The data was analyzed with Wilcoxon rank sum and multivariate linear regression.

Results: Seventy-nine patients (51.9% female) with median age of 64 years (interquartile range (IQR) 55-71) with SSNHL were analyzed. All patients received steroid treatment (17.7% PO only, 24.1% IT only, 25.3% upfront PO and IT, 32.9% upfront PO with salvage IT) and 7.6% underwent hyperbaric oxygen treatment. Initial median PTA and median WRS were 42.5 dB (IQR 31.3-63.8) and -76% (IQR -24- -100) relative to contralateral ear, respectively. Latest median PTA and median WRS were 32.5 dB (IQR 13.8-50) and -40% (IQR -4- -80) relative to contralateral ear, respectively, with median audiologic follow-up of 14.3 months (IQR 7.0-35.7). There were no significant predictors of latest PTA, latest WRS or change in WRS on multivariate linear regression. However, improvement in PTA was significantly associated with upfront combination PO and IT steroids (24.5 dB improvement in PTA relative to PO only, p=0.001) and negatively associated with coronary artery disease (co-efficient -14.6 dB, p=0.025) and active smoking (co-efficient -22.7 dB, p=0.049) when controlling for IT steroids only, upfront PO with salvage IT steroids, time to treatment, gender, age, diabetes, and hyperbaric oxygen use on multivariate linear regression.

Conclusions: Combined upfront PO and IT steroid treatment may have greater PTA improvement relative to other treatments.