Intratympanic Steroid Use for Sudden Sensorineural Hearing Loss: Current Otolaryngology Practice in the Kingdom of Saudi Arabia

Abstract

Abstract Objectives: Sudden sensorineural hearing loss (SSNHL) is commonly defined as a hearing loss of more than 30 decibels in three consecutive frequencies that occurs within 72 h. In most cases, it is considered idiopathic, and an evidence-based strategy to treat it is still debated. We aim to analyze the current practice of intratympanic steroid injection (ITSI) for SSNHL in the Kingdom of Saudi Arabia (KSA) and compare it to the published data from the United Kingdom (UK), the United States (US), and continental Europe. Methodology: A survey of 28 questions was distributed among Otolaryngology Consultants and Specialists of KSA. It includes questions about demographics, indications for IT treatment, procedure, follow-up, and outcomes. Results: We received 75 responses. Around 66% of them indicated that they use ITSI to treat idiopathic SSNHL (ISSNHL). Forty-six percent (n = 23) did not use ITSI as a primary therapy. Forty percent (n = 20) used it in combination with other treatments, including oral steroids, and 14% (n = 7) used it as a primary monotherapy. The majority (36%, n = 18) considered using ITSI for up to 1 month. The commonly used course of treatment for our ear, nose, and throat (ENT) doctors was three injections (50% n = 25), with a weekly dose being the most frequent interval (42% n = 21). Conclusion: This study showed wide variability in practice among Saudi ENT clinicians. This variation has been found across countries, in the UK, US, and continental Europe, which tells us that this is a global issue and there is not yet one unified protocol to be followed in the treatment of ISSNHL.