Sudden Sensorineural Hearing Loss: Why Early Treatment Matters

Sudden sensorineural hearing loss is an otologic emergency that can appear without warning. It is defined as a rapid decline in hearing of more than 30 decibels across three consecutive frequencies within a period of three days or less. Many patients also experience tinnitus, which can be just as distressing as the hearing loss itself.

For decades, oral corticosteroids have been the standard treatment. While effective for many patients, systemic steroids carry notable risks, particularly for individuals with diabetes or hypertension. Because of these limitations, intratympanic steroid therapy has gained significant attention in recent years.

Intratympanic injections deliver steroids directly into the middle ear, achieving much higher cochlear concentrations while reducing systemic exposure. This makes the treatment both targeted and safer for patients who cannot tolerate high-dose oral steroids.

A prospective cohort study conducted by Dr. Goran and colleagues evaluated this approach in 48 patients with sudden sensorineural hearing loss. All patients received six consecutive days of intratympanic dexamethasone injections. More than three quarters of participants presented late, often two weeks or more after symptom onset, yet meaningful improvement was still achieved.

Using Siegel’s criteria, one third of patients experienced complete recovery of hearing, nearly half showed partial recovery, and only a small minority, about eight percent, showed no improvement. Younger age and earlier presentation were strongly associated with better outcomes, reinforcing the importance of prompt assessment and intervention.

The full study was published in the Australian Journal of Otolaryngology and offers important evidence for clinicians seeking more definitive guidance on managing sudden sensorineural hearing loss.

To view the full study you can click here.