Sudden sensorineural hearing loss: What factors influence the response to therapy?

The standard treatment of Sudden Sensorineural Hearing Loss is based on oral steroids. In addition, intratympanic steroid is currently used in patients who fail to respond to oral treatment. The aim of the present study was to evaluate, in patients affected by SSHL, factors that influence the response to systemic and intratympanic steroid treatment. A retrospective analysis was conducted on 149 patients, all treated with systemic steroids. Moreover, patients not responsive to systemic therapy were treated with intratympanic steroids as salvage therapy. Auditory gain was assessed through the recovery rate at the discharge and after 30 days. Statistical analysis demonstrated that patients with delayed treatment and down-sloping auditory curve presented a poor recovery. Linear and stepwise regression showed that hypertriglyceridemia and hyperglycemia were negative prognostic factors. The prognosis of SSHL is affected by hyperglycemia and hypertriglyceridemia suggesting that a microvascular dysfunction within the cochlea could impair hearing recovery. Intratympanic steroid treatment was used as salvage treatment, however in patients with poor prognostic factors or at risk for side effects, it could be used in association with systemic treatment.