{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:57:51Z","timestamp":1785761871225,"version":"3.56.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Oral corticosteroids are treatment mainstays for idiopathic sudden sensorineural hearing loss (SSNHL). Recent studies suggest that intratympanic (IT) steroid injections may be effective as an alternate or adjunctive therapy. We sought to investigate nationwide trends in treatment patterns for SSNHL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A large nationwide health care claims database spanning 2007 to 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with SSNHL were identified from the IBM Watson Health MarketScan Database. Multivariable logistic, linear, and Cox regression were used for demographic\u2010 and comorbidity\u2010adjusted analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 19,670 patients were included. Between 2007 and 2016, use of oral corticosteroids alone decreased (83.6% to 64.6%, <jats:italic>P<\/jats:italic> &lt;. 001), while use of IT corticosteroids alone and combination IT\u2010oral corticosteroids increased (IT only, 7.9% to 15.1%, <jats:italic>P<\/jats:italic> =. 002; IT\u2010oral, 8.5% to 20.4%, <jats:italic>P<\/jats:italic> &lt;. 001). During the study period, time to treatment initiation decreased for both administration modalities, though more dramatically for IT corticosteroids (IT, 124.0 to 10.6\u00a0days, <jats:italic>P<\/jats:italic> &lt;. 001; oral, 42.6 to 12.7\u00a0days, <jats:italic>P<\/jats:italic> &lt;. 001). In patients receiving both IT and oral corticosteroids, concurrent first\u2010line use increased (25.2% to 52.8%, <jats:italic>P<\/jats:italic> &lt;. 001). Repeat injections have also become more common but may raise risk of persistent tympanic membrane perforations (vs no injection; hazard ratio [first injection] = 7.95, 95% CI = 5.54\u201011.42; hazard ratio [fifth or higher injection] = 17.47, 95% CI = 6.93\u201044.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SSNHL management increasingly involves early IT steroids as an alternative or adjunctive option to oral steroids. Use of repeat IT corticosteroid injections has also increased but may raise risk of persistent tympanic membrane perforations and subsequent tympanoplasty. Future decision analysis and cost\u2010effectiveness studies are necessary to identify an optimal care pattern for SSNHL.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820976177","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T12:55:16Z","timestamp":1607604916000},"page":"166-173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Trends in Use and Timing of Intratympanic Corticosteroid Injections for Sudden Sensorineural Hearing Loss"],"prefix":"10.1002","volume":"165","author":[{"given":"Michael C.","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z. Jason","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayna P.","family":"Cooperman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer C.","family":"Alyono","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1084713811408349"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1198\/016214504000000845"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3294-8_3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1980.00790360050013"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e31816fdcb4"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812436449"},{"issue":"7","key":"e_1_2_9_9_1","article-title":"Steroids for idiopathic sudden sensorineural hearing loss","author":"Wei BP","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.679"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318168da7a"},{"issue":"70","key":"e_1_2_9_12_1","first-page":"23","article-title":"Combined intratympanic and systemic steroid therapy for poor\u2010prognosis sudden sensorineural hearing loss","volume":"25","author":"Arastou S","year":"2013","journal-title":"Iran J Otorhinolaryngol"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000245058.11866.15"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000834"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816650175"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819859885"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2016.09.004"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.09.138"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21684"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599820976177","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599820976177","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599820976177","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:20:23Z","timestamp":1760962823000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599820976177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,8]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1177\/0194599820976177"],"URL":"https:\/\/doi.org\/10.1177\/0194599820976177","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,8]]},"assertion":[{"value":"2020-09-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}