Objective: To compare patient response to intratympanic steroid (IT) treatment using the American Academy of Otolaryngology Head and Neck Surgery (AAO-HNSF) guideline vs other reported criteria.
Study Design: Retrospective chart review
Setting: Academic otology practice
Patients:74 patients with a diagnosis of idiopathic sudden sensorineural hearing loss (ISSNHL) between April 2003 and December 2020 were included. All patients had at least 1 treatment with IT steroids and both pretreatment and follow-up audiograms.
Interventions: IT steroid injection
Main Outcome Measures: 1) Determination of the efficacy of IT steroids for ISSNHL using the AAO-HNSF guideline vs other reported criteria; 2) Correlation of clinical and treatment variables with response to IT steroid
Results: PTA-4 using AAO-HNSF reporting criteria demonstrated full recovery in 24.32% of patients. Applying the 8 other reported outcomes criteria to our patients showed full recovery ranging from 14.87% to 40.54% of patients. Similarly, AAOHNSF criteria showed no recovery in 51.35% of patients, while applying the other reported criteria showed no recovery in 51.45% to 82.43% of patients. Low frequencies exhibited full recovery in 33.78% of patients while high frequencies recovered in 27.03%. Younger age (p=0.003, effect size 0.924) and IT injection within a week of onset (p < 0.001, effect size1.099) positively correlated with full recovery. There was no impact of prior or concurrent oral steroids nor number of steroid injections on outcome.
Conclusions: Great variability exists in the literature for assessment of IT steroid outcomes in ISSNHL. AAO-HNSF standardization of outcome measures is necessary to accurately characterize IT steroid efficacy.
*Professional Practice Gap & Educational Need:Lack of accurate information regarding the efficacy of IT steroid treatment for ISSNHL
*Learning Objective: 1) To promote standardization of reporting outcomes for ISSNHL; 2) To recognize variables associated with recovery from ISSNHL
*Desired Result: Utilization of AAO-HNSF guideline as standard for reporting outcomes