Introduction: Intratympanic cortisone injections (ITI) have been established for sudden deafness for years. ITI can be used as primary therapy and, above all, as rescue therapy if systemic administration has not brought any improvement or if there are contraindications to systemic administration. Methods: Many different forms of application, indication, duration and treatment have been used. Different local anesthetics, cortisone preparations, body and head positions are practiced. Results: 103 patients are analyzed. In 55 cases, the injection after oral therapy. In 48 cases, given immediately due to extreme hearing loss or comorbidities the injections are well tolerated with rare unpleasant side effects. Discussion: High-dose treatment with cortisone has been used for decades. The HODOKORT study brought significant dose reductions. The KORTEBO study could not be carried out, but there is need for it. There is a lack of evidence of an optimal indication, implementation and objective proof, which is urgently needed.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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The retrospective data analysis was evaluated and approved by the ethics committee of the Mainz Medical Association under the number 2024-17577-retrospective.

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