European Archives of Oto-Rhino-Laryngology

, Volume 272, Issue 10, pp 2777–2782 | Cite as

Intratympanic steroids as a salvage treatment for sudden sensorineural hearing loss? A meta-analysis

  • Jia Hui Ng
  • Roger Chun Man Ho
  • Crystal Shuk Jin Cheong
  • Adele Ng
  • Heng Wai Yuen
  • Raymond Yeow Seng Ngo


Sudden sensorineural hearing loss is typically treated with systemic steroids. The aim of this meta-analysis was to evaluate the efficacy of salvage intratympanic steroid treatment in patients who have initial treatment failure with systemic steroids. A MEDLINE literature search was performed, supported by searches of Web of Science, Biosis, and Science Direct. Articles of all languages were included. Selection of relevant publications was conducted independently by three authors. Only randomized controlled trials were considered. In one arm of the studies, the patients received salvage intratympanic steroids. In the other arm, patients did not receive further treatment. The standard difference in mean (SDM) amount of improvement in hearing threshold between patients who did and did not receive salvage intratympanic steroids was calculated. From an initial 184 studies found via the search strategy, 5 studies met inclusion criteria and were included. There was a statistically significant greater reduction in hearing threshold on pure-tone audiometry in patients who received salvage intratympanic steroids than in those who did not (SDM = −0.401, p = 0.005). Subgroup analysis showed that administration by intratympanic injection (SDM = −0.375, p = 0.013) rather than a round window catheter (SDM = −0.629, p = 0.160) yielded significant improvement in outcome. The usage of dexamethasone yielded better outcomes (SDM = −0.379, p = 0.039) than the use of methylprednisolone (SDM = −0.459, p = 0.187). No serious side effect of treatment was reported. In patients who have failed initial treatment with systemic steroids, additional treatment with salvage intratympanic dexamethasone injections demonstrate a statistically significant reduction in the hearing thresholds as compared to controls.


Sudden sensorineural hearing loss Intratympanic Steroids Dexamethasone Methylprednisolone Injections Salvage Treatment 



No financial support was received from any parties for this study.

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Jia Hui Ng
    • 1
  • Roger Chun Man Ho
    • 2
  • Crystal Shuk Jin Cheong
    • 3
  • Adele Ng
    • 4
  • Heng Wai Yuen
    • 5
  • Raymond Yeow Seng Ngo
    • 3
  1. 1.Department of OtolaryngologySinghealthSingaporeSingapore
  2. 2.Department of Psychological MedicineNational University HospitalSingaporeSingapore
  3. 3.Department of OtolaryngologyNational University HospitalSingaporeSingapore
  4. 4.Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  5. 5.Department of OtolaryngologyChangi General HospitalSingaporeSingapore

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