IDIOPATHIC SUDDEN SENSORINEURAL HEARING LOSS: CLINICAL AND AUDIOMETRIC RESPONSE TO INTRATYMPANIC STEROIDS AS SALVAGE THERAPY. SIMULATED CASE REPORT AND NARRATIVE REVIEW
Keywords:
Sudden sensorineural hearing loss; intratympanic steroids; dexamethasone; salvage therapy; audiometry; case reportAbstract
DOI: https://doi.org/10.46296/yc.v10i18.0866
Abstract
Background: Idiopathic sudden sensorineural hearing loss is an otologic emergency defined by rapid-onset sensorineural hearing loss, usually unilateral, with no identifiable cause after targeted evaluation. Systemic corticosteroids are commonly offered as initial therapy within the first two weeks, but incomplete recovery is frequent and intratympanic steroids may be used as salvage therapy. Case report: A 42-year-old man presented with right-sided hearing loss of 36 hours, severe tinnitus, and aural fullness, without vertigo or neurologic deficits. Baseline audiometry showed severe right sensorineural hearing loss, with a pure-tone average of 71.3 dB HL and word recognition of 42%. After early oral prednisone, recovery was incomplete (PTA 57.5 dB HL), and salvage intratympanic dexamethasone was administered in four sessions. At six weeks, PTA improved to 32.5 dB HL and word recognition to 84%, with clinically meaningful tinnitus reduction. Conclusion: This case illustrates that timely salvage intratympanic steroid therapy may be associated with functional hearing recovery after incomplete response to systemic steroids. Indication should be guided by serial audiometry, exclusion of retrocochlear disease, risk assessment, and shared decision-making.
Keywords: Sudden sensorineural hearing loss; intratympanic steroids; dexamethasone; salvage therapy; audiometry; case report.
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