Idiopathic Sudden Sensorineural Hearing Loss: Results from Spanish National Registry

Introduction: Idiopathic sensorineural hearing loss (ISSNHL) is usually treated with steroids through different routes and regimens. The objective of this work is to analyze the types of treatment and their response in patients with severe ISSNHL (PTA > 70 dB) from the Spanish National registry of ISSNHL.

Methods: Prospective study of ISSNHL cases from the Spanish National registry of ISSNHL included between January 2021 and December 2022. For inclusion, hearing had to be severe (PTA >70 dB) and follow-up should be done more than 24 months. The treatment groups were divided into three groups: oral corticosteroid, oral and intratympanic corticosteroid, and, finally, intravenous and intratympanic corticosteroid. The main outcome measure was the audiometric response. As secondary variables we have demographic data, comorbidities, delay in starting treatment, etiological diagnosis and type of treatment.

Results: During the 24 months of study, 263 patients diagnosed with ISSNHL have been registered, with 267 cases in total (including 6 simultaneous bilateral cases). The average age was 57.54 years, with 54.75% women and 45.24% men. The mean time to start of treatment was 14.3 days (range 0-300). Regarding the type of treatment, 76 (29.5%) received treatment with oral steroids, 133 (49.5%) received treatment with oral and intratympanic steroids, while 58 (21%) were treated with intravenous and intratympanic. In the group of patients treated with oral steroids, 67% showed recovery (21 cases completely, and 30 partially). In patients treated with oral and intratympanic steroids, 61% recovered (17 cases completely and 65 partial). Finally, those treated with intravenous and intratympanic recovered in 59% of the cases (8 completely and 26 partially), with statistically similar results, regardless of the route of administration.

Conclusions: In this National Registry on ISSNHL including severe cases (PTA >70 dB), audiometric improvement was similar, regardless of the route of steroid treatment.