Beyond steroid monotherapy: a systematic review and meta-analysis of combination therapy for severe to profound sudden sensorineural hearing loss

To systematically evaluate the comparative efficacy of initial combination therapy with systemic and intratympanic corticosteroids versus systemic corticosteroid monotherapy for hearing recovery in patients with severe or profound Sudden Sensorineural Hearing Loss (SSNHL).

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Audiologists and ENTs managing severe-to-profound sudden sensorineural hearing loss should be aware that this meta-analysis supports combination systemic plus intratympanic corticosteroid therapy over systemic steroids alone — referral pathways and counselling for at-risk patients may warrant review pending local protocol updates.

Sudden sensorineural hearing loss remains an otologic emergency with variable recovery; higher-level evidence supporting combination steroid therapy could shift treatment guidelines and improve outcomes for the most severely affected patients.

1. 01Systematic review and meta-analysis comparing combination corticosteroid therapy vs. systemic steroids alone.
2. 02Population: patients with severe-to-profound sudden sensorineural hearing loss (SSNHL).
3. 03Combination therapy (systemic + intratympanic steroids) showed superior hearing recovery over monotherapy.
4. 04Published in Brazilian Journal of Otorhinolaryngology (Braz J Otorhinolaryngol).
5. 05Findings may support updating clinical protocols for high-severity SSNHL cases.

PMID

42531678

DOI

10.1016/j.bjorl.2026.101849.

Journal

Brazilian Journal of Otorhinolaryngology

Publication type

meta_analysis

Evidence level

1a

Population

Patients with severe-to-profound sudden sensorineural hearing loss

Intervention

Combination systemic and intratympanic corticosteroid therapy

Comparator

Systemic corticosteroid monotherapy