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Purpose <p>To describe real-world hearing outcomes after salvage intratympanic corticosteroid (ITC) therapy in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and incomplete recovery after systemic corticosteroids, emphasizing clinically meaningful recovery.</p> Methods <p>Prospective observational study at a single tertiary center. Patients met ISSNHL diagnostic criteria (≥ 30 dB loss in ≥ 3 consecutive frequencies within 72&#xa0;h) and received salvage ITC (methylprednisolone 40&#xa0;mg/mL, weekly for 3 weeks) after absent or incomplete recovery on follow-up audiometry (day 10–15). Primary outcome was PTA4 change from pre-salvage audiogram to last available audiogram (minimum follow-up 1 month). Recovery was categorized using Siegel criteria. Non-parametric methods and Hodges–Lehmann estimators were used.</p> Results <p>Of 83 ISSNHL patients, 41 received salvage ITC and were analyzed. In the salvage cohort, 63.4% were women; mean age was 53.3 years (95% CI 46.7–59.9); median follow-up was 11 months (IQR 3–15). Median PTA gain attributed to ITC rescue was 5.0 dB (IQR − 3.8 to 18.8; padj = 0.043). After salvage ITC, 71% showed ≤ 15 dB improvement; 29% achieved ≥ 15 dB. By Siegel criteria, normal hearing was achieved in 7%, mild-to-moderate loss in 34%, and severe loss in 59%.</p> Conclusion <p>Salvage ITC was associated with a statistically significant but clinically modest hearing gain and a low proportion of complete recovery. Standardized, patient-relevant outcome definitions are needed to support realistic counseling.</p>

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Clinical effectiveness of salvage intratympanic corticosteroids for idiopathic sudden sensorineural hearing loss: a real-world observational series

  • 期刊论文

  • 发表日期：

    2026年8月3日

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  • Laura Gálvez Gafo,
  • Carlos Carazo-Casas,
  • Miguel Vaca González,
  • Rubén Polo López,
  • María del Mar Medina González

摘要

Purpose

To describe real-world hearing outcomes after salvage intratympanic corticosteroid (ITC) therapy in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and incomplete recovery after systemic corticosteroids, emphasizing clinically meaningful recovery.

Methods

Prospective observational study at a single tertiary center. Patients met ISSNHL diagnostic criteria (≥ 30 dB loss in ≥ 3 consecutive frequencies within 72 h) and received salvage ITC (methylprednisolone 40 mg/mL, weekly for 3 weeks) after absent or incomplete recovery on follow-up audiometry (day 10–15). Primary outcome was PTA4 change from pre-salvage audiogram to last available audiogram (minimum follow-up 1 month). Recovery was categorized using Siegel criteria. Non-parametric methods and Hodges–Lehmann estimators were used.

Results

Of 83 ISSNHL patients, 41 received salvage ITC and were analyzed. In the salvage cohort, 63.4% were women; mean age was 53.3 years (95% CI 46.7–59.9); median follow-up was 11 months (IQR 3–15). Median PTA gain attributed to ITC rescue was 5.0 dB (IQR − 3.8 to 18.8; padj = 0.043). After salvage ITC, 71% showed ≤ 15 dB improvement; 29% achieved ≥ 15 dB. By Siegel criteria, normal hearing was achieved in 7%, mild-to-moderate loss in 34%, and severe loss in 59%.

Conclusion

Salvage ITC was associated with a statistically significant but clinically modest hearing gain and a low proportion of complete recovery. Standardized, patient-relevant outcome definitions are needed to support realistic counseling.