Simultaneous Therapy Approach - Systemic and Intratympanic Corticosteroid for Idiopathic Sudden Sensorineural Hearing Loss - A Clinical Study

Sep 30, 2026

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Idiopathic sudden sensorineural hearing loss (ISSNHL) is addressed through combined systemic and intratympanic corticosteroid injections, evaluating hearing gains and related symptom outcomes. A retrospective analysis reviews 73 patients in the Khorasan Razavi registry from 2022 to 2024. One month post-treatment, Modified Siegel’s criteria show complete, partial, and slight improvement in 30%, 14%, and 16% of cases, respectively. Tinnitus and vertigo also improve substantially, supporting efficacy in about sixty percent of patients.

LanguageEnglish

CategoryHealthcare

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Abstract

Introduction

Materials and Methods

Patients

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Simultaneous Therapy Approach: Systemic and Intratympanic Corticosteroid for Idiopathic Sudden Sensorineural Hearing Loss: A Clinical Study Mohsen Rajati 1, Imaneh Roshanzamir 1, Ermia Mousavi Mohammadi2, Romina Tavasoli3, *Sadegh Jafarzadeh4 Abstract Introduction: Idiopathic Sudden sensorineural hearing loss (ISSNHL) can be treated with various methods. This study investigated the impact of combined systemic and intratympanic corticosteroid injections on hearing improvement and associated symptoms in patients with ISSNHL.Top of Form. Materials and Methods: The study investigated the recovery process of 73 patients with ISSNHL from Khorasan Razavi registry between the years 2022 to 2024. These patients received treatment involving both systemic and intratympanic corticosteroid. Results: One month after treatment, the study using Modified Siegel's criteria found complete, partial, and slight improvement in 30%, 14%, and 16% of patients, respectively. During this period, 24% of cases with tinnitus were completely treated, while 51% experienced partial relief. For cases with vertigo, 67% were completely treated, and 33% had partial improvement. Conclusion: Combined corticosteroid treatment is effective in approximately sixty percent of ISSNHL cases. This therapy also demonstrates success in alleviating related symptoms such as tinnitus and vertigo. Keywords: Sensorineural hearing loss, Sudden hearing loss, Corticosteroids, Vertigo, Tinnitus. Received date: 25 Jul 2025 Accepted date: 06 Oct 2025 *Please cite this article; Rajati M, Roshanzamir I, Mousavi-Mohammadi E, Tavasoli R, Jafarzadeh S. Simultaneous Therapy Approach: Systemic and Intratympanic Corticosteroidfor Idiopathic Sudden Sensorineural Hearing Loss: A Clinical Study Iran J Otorhinolaryngol. 2025:37(6): 327-334. Doi: 10.22038/ijorl.2025.89180.3984 1Sinus and Surgical Endoscopic Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2Department of Otorhinolaryngology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 3Department of Otorhinolaryngology, School of Medicine, Mashhad University of Medical Sciences, Mashhad. 4Department of Audiology, School of Paramedical and rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran. *Corresponding author: Department of Audiology, School of Paramedical and rehabilitation Sciences, campus of Mashhad University of Medical Sciences, park square, Mashhad, [Iran. E-mail: jafarzadehs@mums.ac.ir](Iran. E-mail: jafarzadehs@mums.ac.ir) Introduction Idiopathic Sudden sensorineural hearing loss (ISSNHL) is characterized by a rapid onset of hearing loss upon waking up or a gradual loss of hearing (30 dB in 3 consecutive frequencies) over up to 72 hours in one or both ears. This can be a frightening experience for patients and should be treated as an emergency (1) . The causes of ISSNHL are not fully understood, but various factors such as idiopathic, infectious, trauma, vascular, neoplastic, immunological, andototoxic drugs have been suggested. However, the direct link between ISSNHL and these factors is still unknown. The incidence of ISSNHL is reported to be 5 to 20 per 100,000 per year. Around 30 to 65% of ISSNHL cases may resolve spontaneously. The prognosis of recovery depends on various factors, including the patient's age, the presence of vertigo at the time of onset, the degree and pattern of hearing loss, and the time between the onset of hearing loss and treatment (1,2) . ISSNHL can also be related to factors such as atherosclerosis (3) . As most cases are idiopathic, empiric treatment includes systemic and intratympanic injections of corticosteroids, antiviral and vasodilator agents, diuretics, and hyperbaric oxygen. However, due to the lack of complete knowledge, the treatment method is still controversial, and there is no strong evidence for any of the treatment options (1) . Furthermore, patien

FAQs

What treatment approach was investigated for ISSNHL?

The study evaluated combined systemic corticosteroid injections together with intratympanic corticosteroid injections.

How many patients were included, and what time period was studied?

Seventy-three patients were analyzed, drawn from the Khorasan Razavi registry covering 2022 to 2024.

What hearing improvement outcomes were reported one month after treatment?

Using Modified Siegel’s criteria, 30% showed complete improvement, 14% partial improvement, and 16% slight improvement after one month.

Sep 30, 2026

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