Clinical applicability
This study has shown salvage ITS therapy to be effective in a minority of patients (15-24%), however for these patients it represents a final attempt at treating their SSNHL. ITS therapy can be uncomfortable for patients and sometimes can provoke feelings of dizziness post procedure. The procedure itself is known to carry a small risk of perforation. Only one patient was documented to have evidence of tympanic membrane perforation 6 weeks post ITS injection in this study. This study provides further evidence of a trend towards greater improvement being more likely to be found in those with a greater degree of hearing loss. It offers valuable real world experience that will enable balanced discussion with the patient regarding the likely risks and benefits of salvage ITS therapy. Additionally, this study will guide future departmental decision making regarding our service for managing SSNHL. This may involve implementing a more accelerated ITS regimen or selectively offering ITS therapy only to those with more severe hearing loss.