Objective  To investigate the clinical efficacy of intratympanic corticosteroids (ITS) and hyperbaric oxygen therapy (HBOT) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) who had failed systemic corticosteroid (SS) treatment.

Methods  ISSNHL patients admitted to the Department of Otolaryngology, First People's Hospital of Linping District of Hangzhou city from January 2020 to January 2023 were retrospectively collected. According to the treatment plan, patients with ISSNHL were divided into SS group, HBOT group, and ITS group. The changes in hearing level [purity hearing threshold mean (PTA)] and hearing gain of ISSNHL patients before treatment (T₀), day 5 (T₁) and after 3 months of treatment (T₂) were observed and compared, and the total effective rate of treatment in different groups was compared. Univariate analysis was used to explore the influencing factors of the efficacy of patients with different treatment modalities of ISSNHL.

Results  A total of 156 ISSNHL patients were included, including 70 in the SS group, 33 in the HBOT group and 53 in the ITS group. At T₀, there was no significant difference in PTA among the three groups of patients (P>0.05). At T₂, the level of PTA in the three groups of ISSNHL patients was significantly lower than that before treatment (P<0.05). The levels of PTA in the HBOT group and ITS group were significantly lower than those in the SS group (P<0.05). The level of PTA in the HBOT group was significantly lower than that in the ITS group (P<0.05). The hearing gain of the HBOT group and the ITS group was significantly higher than that of the SS group (P<0.05), and the hearing gain of the HBOT group was significantly higher than that of the ITS group (P<0.05). The total effective rate of HBOT group was significantly higher than that of ITS group (P<0.05), and the total effective rate of ITS group was significantly higher than that of SS group (P<0.05). In addition, vertigo was an influencing factor for poor hearing recovery in ISSNHL patients regardless of treatment regimen (P<0.05).

Conclusion  Both ITS and HBOT can improve the treatment efficiency of ISSNHL patients who have failed SS treatment and promote hearing recovery in ISSNHL. Compared with IST, HBOT has more significant efficacy, and it is recommended that clinical treatment be prioritized. Vertigo is an influencing factor for poor hearing recovery in patients with ISSNHL who have failed SS treatment, and should be focused on in clinical practice.

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