Clinically, the success rate of Intratympanic steroid therapy in patients with SHL is variable in the literature and the available studies are limited to retrospective and non-controlled prospective ones. In those studies steroids were used in various concentrations, regimens and delivery methods and their effectiveness have not been established due to the lack of randomized controlled trials. There have been some studies in the literature that discussed the effectiveness of Intratympanic steroid therapy as a salvage mode of therapy in patients who failed to respond to oral steroids (Herr & Marzo 2005, Slattery et al 2005).
Results In the oral prednisone group, PTA improved by dB compared with a -dB improvement in the intratympanic treatment group. Mean pure tone average at 2 months was for the oral steroid treatment group and dB for the intratympanic treatment group. Recovery of hearing on oral treatment at 2 months by intention-to-treat analysis was dB greater than intratympanic treatment (% upper confidence interval, dB). Per-protocol analysis confirmed the intention-to-treat result. Thus, the hypothesis of inferiority of intratympanic methylprednisolone to oral prednisone for primary treatment of sudden sensorineural hearing loss was rejected.