Introducci?n y objetivos: La sordera s?bita idiop?tica se define habitualmente, como una p?rdida auditiva superior o igual a 30 dB HL, en 3 o m?s frecuencias consecutivas, con un tiempo de instauraci?n inferior a 72 horas, de causa desconocida. Siendo actualmente motivo de discusi?n el efecto de la terapia esteroidea en este s?ndrome, evaluaremos la eficacia del corticoide intratimp?nico (CIT) como tratamiento de rescate. Como objetivo secundario, estudiaremos la influencia de determinados factores considerados de riesgo o pron?stico. Pacientes y m?todos: Se comparan los resultados de dos grupos de poblaci?n con edad y p?rdida auditiva similar. El primero, de 99 pacientes, recibi? exclusivamente tratamiento sist?mico con corticoides. En el segundo de 70, con una sordera s?bita idiop?tica refractaria al tratamiento general, instilamos corticoide intratimp?nico. Comparamos las diferencias de umbral medio auditivo en el momento del diagn?stico y a los 3 meses, adem?s del grado general de recuperaci?n. Resultados: La aplicaci?n intratimp?nica de 3 dosis de dexametasona (8mg/ml) en la sordera s?bita idiop?tica refractaria, no ha producido, en nuestra poblaci?n, un cambio significativo respecto al tratamiento sist?mico. Analizamos tambi?n la influencia de los factores pron?sticos seleccionados. Discusi?n: Desconocemos la eficacia del tratamiento con corticoides en la sordera s?bita idiop?tica. El tipo de lesi?n y las caracter?sticas del paciente podr?an ser decisivos en el pron?stico final y en el resultado terap?utico. Conclusiones: El tratamiento de rescate con CIT, no ha aportado mejor?a auditiva significativa en la poblaci?n estudiada. Los factores con peor pron?stico son: la presencia de s?ntomas vestibulares, la hipoacusia de grado profundo, la ca?da audiom?trica hacia tonos agudos, el inicio del tratamiento despu?s de 2 semanas y fundamentalmente, la falta de mejor?a de al menos 10 dB el 4? d?a de tratamiento./n

Introduction and objectives: Idiopathic Sudden Sensorineural Hearing Loss (ISSNHL) is commonly defined as greater than 30 dB of hearing loss in at least 3 audiometric frequencies occurring over 3 days or less, of unknown cause. Since the effect of steroid therapy in this syndrome is currently under discussion, we will evaluate the efficacy of intratympanic corticosteroid (ITC) as rescue treatment. As a secondary objective, we will study the influence of certain factors considered risk or prognostic. Patients and methods: The results of two population groups with similar age and hearing loss are compared. The first of 99 patients received exclusively systemic treatment with corticosteroids. In the second group of 70, with ISSNHL refractory to general treatment, we instilled intratympanic corticosteroids. We compared the differences in mean hearing threshold at diagnosis and at 3 months, as well as the general degree of recovery. Results: Intratympanic application of 3 doses of dexamethasone (8mg/ml) in refractory ISSNHL did not produce, in our population, a significant change with respect to systemic treatment. We also analyzed the influence of selected prognostic factors. Discussion: We do not know the efficacy of corticosteroid treatment in idiopathic sudden deafness. The type of lesion and patient characteristics could be decisive in the final prognosis and therapeutic outcome. Conclusions: Rescue treatment with ITC has not provided significant hearing improvement in the population studied. The factors with the worst prognosis are the presence of vestibular symptoms, profound hearing loss, high-frequency hearing loss in audiometry, the beginning of treatment after 2 weeks and fundamentally, the lack of improvement of at least 10 dB on the 4th day of treatment./n