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Objective <p>This study evaluated the efficacy and safety of multimodal outpatient therapy compared with conventional inpatient therapy during the initial treatment of sudden sensorineural hearing loss (SSNHL). The goal was to provide reference evidence to support early multimodal treatment strategies for SSNHL.</p> Methods <p>A retrospective analysis was conducted on 1783 patients with SSNHL treated at our institution between August 2014 and July 2025. According to the initial treatment strategy, patients were divided into a multimodal therapy group (Group A, <i>n</i> = 311) and a conventional therapy group (Group B, <i>n</i> = 1321). Group A received outpatient intratympanic and retroauricular injections of compound betamethasone combined with oral medications, whereas Group B received inpatient retroauricular methylprednisolone injection combined with intravenous medications. Propensity score matching (PSM) was applied to balance confounding factors. The primary outcomes were puretone threshold improvement and effective rate at 8-12 weeks after treatment.</p> Results <p>After PSM, a total of 726 patients were included in the final analysis (Group A, <i>n</i> = 285; Group B, <i>n</i> = 441). There was no significant difference in initial hearing thresholds between the two groups (<i>P</i> = 0.728), with values of 72.52 ± 22.54 dB HL (IQR 72.50 dB HL) in Group A and 73.54 ± 24.04 dB HL (IQR 72.50 dB HL) in Group B. At 8-12 weeks after treatment, final hearing thresholds differed between the groups (<i>P</i> &lt; 0.001), with Group A at 37.00 ± 21.30 dB HL (IQR 34.20 dB HL) and Group B at 49.11 ± 27.47 dB HL (IQR 47.70 dB HL). The total effective rate in Group A was 90.2% (complete recovery 42.5%, significant improvement 31.9%, slight improvement 15.8%), compared with 65.5% in Group B (complete recovery 31.2%, significant improvement 17.5%, slight improvement 16.8%), and the difference was statistically significant (<i>P</i> &lt; 0.001). Both groups experienced low rates of mild and transient events during the 8-12 weeks followup period, with no serious complications observed.</p> Conclusion <p>In the matched cohort, multimodal outpatient therapy was associated with greater hearing improvement, and no serious complications were observed during the followup period. These findings suggest that, under the conditions of this study, multimodal outpatient therapy may offer potential advantages with acceptable shortterm safety. The results provide preliminary retrospective observational evidence for optimizing early intervention strategies for SSNHL in specific clinical settings, although prospective randomized controlled trials are still needed for further validation.</p>

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Efficacy of multimodal therapy for sudden sensorineural hearing loss: a propensity score-matched analysis of 1632 patients

  • 期刊论文

  • 发表日期：

    2026年3月15日

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  • Guorui Li,
  • Chenhua Wang,
  • Yuanhui Gao,
  • Jialin Xia,
  • Jianfeng Li,
  • Chengfang Chen

摘要

Objective

This study evaluated the efficacy and safety of multimodal outpatient therapy compared with conventional inpatient therapy during the initial treatment of sudden sensorineural hearing loss (SSNHL). The goal was to provide reference evidence to support early multimodal treatment strategies for SSNHL.

Methods

A retrospective analysis was conducted on 1783 patients with SSNHL treated at our institution between August 2014 and July 2025. According to the initial treatment strategy, patients were divided into a multimodal therapy group (Group A, n = 311) and a conventional therapy group (Group B, n = 1321). Group A received outpatient intratympanic and retroauricular injections of compound betamethasone combined with oral medications, whereas Group B received inpatient retroauricular methylprednisolone injection combined with intravenous medications. Propensity score matching (PSM) was applied to balance confounding factors. The primary outcomes were puretone threshold improvement and effective rate at 8-12 weeks after treatment.

Results

After PSM, a total of 726 patients were included in the final analysis (Group A, n = 285; Group B, n = 441). There was no significant difference in initial hearing thresholds between the two groups (P = 0.728), with values of 72.52 ± 22.54 dB HL (IQR 72.50 dB HL) in Group A and 73.54 ± 24.04 dB HL (IQR 72.50 dB HL) in Group B. At 8-12 weeks after treatment, final hearing thresholds differed between the groups (P < 0.001), with Group A at 37.00 ± 21.30 dB HL (IQR 34.20 dB HL) and Group B at 49.11 ± 27.47 dB HL (IQR 47.70 dB HL). The total effective rate in Group A was 90.2% (complete recovery 42.5%, significant improvement 31.9%, slight improvement 15.8%), compared with 65.5% in Group B (complete recovery 31.2%, significant improvement 17.5%, slight improvement 16.8%), and the difference was statistically significant (P < 0.001). Both groups experienced low rates of mild and transient events during the 8-12 weeks followup period, with no serious complications observed.

Conclusion

In the matched cohort, multimodal outpatient therapy was associated with greater hearing improvement, and no serious complications were observed during the followup period. These findings suggest that, under the conditions of this study, multimodal outpatient therapy may offer potential advantages with acceptable shortterm safety. The results provide preliminary retrospective observational evidence for optimizing early intervention strategies for SSNHL in specific clinical settings, although prospective randomized controlled trials are still needed for further validation.