Braz J Otorhinolaryngol. 2018;84(1):28---33 www.bjorl.org Brazilian Journal of OTORHINOLARYNGOLOGY ARTIGO ORIGINAL Intratympanic steroid injection and hyperbaric oxygen therapy for the treatment of refractory sudden hearing loss  Filiz Gülüstan a , Zahide Mine Yazıcı a , Wesam M.E. Alakhras a , Omer Erdur b , Harun Acipayam a,* , Levent Kufeciler a e Fatma Tulin Kayhan a a Bakirkoy Dr Sadi Konuk Training and Research Hospital, Otolaryngology Clinic, Istanbul, Turquia b Selcuk University, Otolaryngology Department, Konya, Turquia Recebido em 24 de agosto de 2016; aceito em 25 de outubro de 2016 Disponível na Internet em 20 de junho de 2017 KEYWORDS Salvage treatment; Intratympanic treatment; Hyperbaric oxygen therapy; Sudden hearing loss Abstract Introduction: Controversy surrounds the use of salvage therapies to treat sudden sensorineu- ral hearing loss (SSNHL), with no consensus on recommendations. While several studies have demonstrated the effectiveness of intratympanic administration of steroids (ITS) and hyperba- ric oxygen (HBO) treatment, few have compared the efficacy of ITS and HBO therapy in patients with refractory SSNHL. Objective: We evaluated the efficiency of ITS and HBO therapy in patients with refractory SSNHL. Methods: Patients who did not adequately benefit from systemic treatment were evaluated retrospectively. Refractory patients were defined as those who gained less than 20 dB in hearing after initial treatment. All refractory patients were informed about salvage therapy options: ITS or HBO therapy, the advantages and disadvantages of which were explained briefly. ITS involved 4 mg/mL dexamethasone administered through a 25 gauge needle. Patients underwent HBO therapy in a hyperbaric chamber where they breathed 100% oxygen for 120 min at 2.5 atmospheric pressure. The hearing levels of both groups were evaluated before the salvage therapy and at 3 months after treatment. Improvements in hearing were evaluated according to the Furahashi criteria. We also compared the two therapies in terms of speech discrimination scores (SDSs) and the recovery of all frequencies. Results: The salvage therapies generated similar results. Changes in pure tone averages and SDSs were similar for ITS and HBO therapy (p = 0.364 and p = 0.113). Comparison of SDSs and hearing thresholds at all frequencies showed similar levels of improvement. DOI se refere ao artigo: http://dx.doi.org/10.1016/j.bjorl.2016.10.013  Como citar este artigo: Gülüstan F, Yazıcı ZM, Alakhras WM, Erdur O, Acipayam H, Kufeciler L, et al. Intratympanic steroid injection and hyperbaric oxygen therapy for the treatment of refractory sudden hearing loss. Braz J Otorhinolaryngol. 2018;84:28---33. ∗ Autor para correspondência. E-mail: harunacipayam@gmail.com (H. Acipayam). A revisão por pares é da responsabilidade da Associac ¸ão Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. 2530-0539/© 2016 Associac ¸˜ ao Brasileira de Otorrinolaringologia e Cirurgia C´ ervico-Facial. Publicado por Elsevier Editora Ltda. Este ´ e um artigo Open Access sob uma licenc ¸a CC BY (http://creativecommons.org/licenses/by/4.0/).