1*Final year Postgraduate, Department of ENT, Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chromepet, Chennai – 600044, Tamil Nadu, India. Mail ID: mons.jawa@gmail.com. ORCID iD: 0009-0000-4024-4083
2Professor and HOD, Department of ENT, Sree Balaji Medical College and Hospital, 7, CLC Works Road, Shankar Nagar, Chrompet, Chennai - 600044. Email: drmkrent@gmail.com
Background
Sudden sensorineural hearing loss (SSNHL) is an otologic emergency characterized by rapid onset hearing impairment. Systemic corticosteroids remain the standard first-line treatment; however, a subset of patients demonstrates incomplete or absent recovery. Intratympanic steroid administration has emerged as an alternative or adjunct therapeutic strategy.
Objective
To evaluate the clinical effectiveness of intratympanic dexamethasone as adjunct therapy in patients with SSNHL who showed inadequate response to systemic steroid treatment.
Methods
This case series included two patients presenting within 24–72 hours of unilateral SSNHL. Both patients received intravenous methylprednisolone (1 g) as initial management without significant audiological improvement. Salvage therapy was administered using intratympanic dexamethasone (8 mg per injection; 0.3–0.8 mL), delivered through the posteroinferior quadrant of the tympanic membrane. Three injections were given on alternate days. Clinical and audiometric assessments were performed before and after treatment.
Results
Both patients demonstrated clinically significant hearing improvement following intratympanic dexamethasone therapy after failure of systemic steroids. Post-treatment audiometry revealed functional recovery consistent with established criteria for meaningful hearing gain (≥10–15 dB improvement across affected frequencies). No procedural complications, including persistent tympanic membrane perforation, vertigo, or infection, were observed. The observed improvement aligns with published meta-analytic data reporting average hearing gains in the range of 10–25 dB with intratympanic therapy.
Conclusion
Intratympanic dexamethasone appears to be a safe and effective adjunct treatment in SSNHL patients with inadequate response to systemic corticosteroids. Early salvage intratympanic therapy may enhance auditory recovery while minimizing systemic adverse effects.
MeSH Keywords
Sudden Sensorineural Hearing Loss; Intratympanic Injections; Dexamethasone; Corticosteroids; Salvage Therapy; Hearing Recovery; Middle Ear; Cochlea; Round Window Membrane; Audiometry.
How to cite this article: Monica J, Rajasekar MK. Intratympanic Dexamethasone as Adjunct Therapy in Sudden Sensorineural Hearing Loss: A Two-Case Series. Int J Drug Deliv Technol. 2026;16(10s): 449-454; DOI: 10.25258/ijddt.16.10s.57
Source of support: Nil.
Conflict of interest: None