Intratympanic steroid injection versus oral steroid as treatment of post COVID-19 Sudden sensorineural hearing loss (SSNHL)

Abstract

Background: At the end of 2019 the world was attacked by coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus, there is a direct association between COVID-19 and SSNHL. Corticosteroids are widely used as a first-line treatment option for SSNHL. Our objective was to evaluate and compare between the efficacy of both known treatments of SSNHL, which are oral steroid versus intratympanic steroid injection in post COVID 19 hearing loss. Patients and methods: Twenty patients with confirmed COVID-19 reported SSNHL were included in this study with different degrees of hearing loss ranged from mild to profound hearing loss. Different approach of steroid therapy including intratympanic steroid injection, high dose oral steroid and both systemic steroid with intratympanic injection. Results: There were no statistically significant differences in the mean of each frequency pre and post treatment audiogram, but there was significant difference in overall change in frequencies which means general improvement. In the other hand there was significant difference between the mean of post treatment low and high frequencies thresholds with more improvement in low than high frequencies. Compering the three groups, there was statistically significant difference in median of all frequencies between the group receiving systemic steroid and the other two groups. Conclusion: COV-SARS-2 virus infection seems to induce SSNHL, Early treatment for sudden hearing loss induced by COVID-19 with high dose of systemic steroid is the most probable option of treatment, and intratympanic injection can be used as a salvage treatment.