Efficacy and safety of intracochlear corticosteroid delivery as salvage therapy for complete sudden sensorineural hearing loss

Complete idiopathic sudden sensorineural hearing loss (ISSNHL, defined as pure-tone average ≥ 95 dB HL according to the 2021 WHO hearing loss classification) is a refractory otoneurological emergency with extremely poor prognosis. Conventional intratympanic therapy depends on passive diffusion across the round window membrane, leading to inadequate intracochlear drug accumulation and limited hearing recovery....

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Intracochlear corticosteroid delivery as salvage therapy for complete idiopathic sudden SNHL (≥95 dB HL) appears to have a measurable efficacy and safety profile, but clinicians should weigh the evidence level carefully before adopting it outside specialist centres given the procedural risk and limited data.

Complete sudden SNHL carries a very poor prognosis with standard salvage options, making any intervention with demonstrated benefit highly significant for this difficult-to-treat population.

1. 01Evaluates intracochlear (directly into the inner ear) corticosteroid injection as salvage for the most severe sudden hearing loss (≥95 dB HL).
2. 02Addresses a population that has already failed conventional steroid treatments.
3. 03Both efficacy (hearing recovery) and safety (adverse events) are reported outcomes.
4. 04Published in Hearing Research, a peer-reviewed audiology journal.
5. 05Results may inform future salvage-therapy guidelines for complete sudden SNHL.

PMID

42822221

DOI

10.1016/j.heares.2026.109805.

Journal

Hearing Research

Publication type

research_article

Evidence level

4

Population

Patients with complete idiopathic sudden sensorineural hearing loss (PTA ≥95 dB HL) who failed prior steroid treatment

Intervention

Intracochlear corticosteroid delivery (salvage therapy)