Intratympanic Corticosteroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss is a frightening condition where a person wakes up — or notices during the day — that their hearing has dramatically worsened in one ear, without any obvious cause. It is a medical emergency, and quick treatment is essential to give the best chance of recovery. The current standard care is oral corticosteroids (steroid tablets), but an additional approach called intratympanic injection — where a corticosteroid is injected directly through the eardrum into the inner ear — may offer additional benefit. This randomised crossover trial will test whether adding an injection of dexamethasone (a type of steroid) directly into the ear, in addition to the standard course of oral prednisolone, improves hearing recovery. Each participant will receive two injections at separate visits — one active drug and one placebo — with neither the patient nor the doctor knowing which is which. Hearing tests will be performed before each injection to track progress. You may be eligible if you have experienced a sudden, unexplained drop in hearing in one ear that began within the past 7 days, confirmed on a hearing test (at least a 20 dB loss across three frequencies), with no other neurological symptoms and no other explanation for the hearing loss. You would not be eligible if you have another identified cause of sensorineural hearing loss, a history of fluctuating hearing loss, or medical conditions that make steroid treatment unsafe, such as uncontrolled diabetes or high blood pressure.