Early initiation of corticosteroid-based therapy and younger patient age were associated with improved hearing in sudden deafness, according to a retrospective study of 248 patients. Those who began treatment within 7 days showed greater hearing gains in flat descending and total deafness subtypes compared with patients who started treatment following 14 days. Younger patients also experienced better outcomes than older patients in flat descending and low-frequency descending subtypes. Tinnitus improvement was more common with earlier treatment and among younger patients, while vertigo outcomes were favorable across groups regardless of age or timing.
Adjunctive treatments produced variable results. Batroxobin and acupuncture did not improve recovery compared with corticosteroids alone. Hyperbaric oxygen therapy (HBOT) was associated with smaller hearing gains in patients with total deafness and low-frequency descending subtypes. Among patients with poor response to systemic therapy, intratympanic corticosteroid (ITC) rescue led to additional hearing improvement, particularly in those with total deafness.
The study analyzed unilateral cases of sudden deafness treated between July 2020 and May 2022 at a single hospital in Chongqing, China. Patients were classified into four subtypes: flat descending, total deafness, low-frequency descending, and high-frequency descending. Outcomes were measured by changes in pure-tone thresholds and improvement in tinnitus and vertigo. Seventeen patients who did not initially respond to systemic therapy later received ITC injections.
The authors noted several limitations. The study was retrospective and conducted at a single institution, which may affect generalizability. The number of ITC injections was uniform among patients, preventing analysis of different dosing regimens. The relatively small sample size also limited the strength of conclusions.
Liang'e Zhi, MD, of the Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of the Army Medical University, and colleagues, suggested a possible explanation for the negative findings with HBOT. Common adverse reactions to HBOT include tympanic membrane congestion, edema, and effusion; HBOT may therefore exacerbate inner-ear exudation and hydrops, potentially worsening prognosis, particularly in low-frequency descending cases.
No conflicts of interest were disclosed.
