ABSTRACT
Sudden sensorineural hearing loss (SSNHL) is an otological emergency. It often affects healthy individuals and is an alarming symptom that impacts on quality of life. The aetiology remains controversial, but early diagnosis and treatment can significantly improve hearing outcomes. A number of hypotheses have been proposed for the aetiology of idiopathic SSNHL. These include labyrinthine viral infection, vascular insult, intracochlear membrane rupture and autoimmune inner ear disease. Steroid therapy is widely accepted as the standard treatment for SSNHL; however, the evidence is limited. Systematic reviews and meta-analyses revealed no evidence of benefit of steroids over placebo. Intratympanic (IT) steroid therapy has been used as a treatment for SSNHL. The main theoretical advantages of intratympanic treatment is the reduction in systemic corticosteroid side effects and better cochlear penetration. Intratympanic injection achieves higher inner ear steroid concentrations. IT steroids have been used as the primary treatment, in combination with other therapies and as salvage treatment.
