Association Between Tinnitus and Hearing Recovery in Sudden Sensorineural Hearing Loss: A Meta-analysis

Objective: To investigate the association between tinnitus and hearing recovery prognosis in patients with sudden sensorineural hearing loss (SSHL). Data sources: PubMed, Web of Science, and Embase. Materials and methods: Eligible studies published between 1983 and 2025 were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS; scores ≥7 indicated high quality). Data were pooled using an inverse-variance random-effects model, with results presented through forest plots. Publication bias and sensitivity analyses were performed. Results: Among 4782 patients from 10 studies, 3590 had SSHL with tinnitus, while 1192 had SSHL without tinnitus. All included studies had NOS scores ≥7. The hearing recovery rate was higher in the tinnitus group (57.44%) than in the non-tinnitus group (50.84%). Tinnitus was positively associated with better hearing recovery [odds ratio (OR) = 0.60; 95% CI, 0.42-0.85; I 2 = 67.2%]. Subgroup analyses using Siegel criteria and systematic corticosteroid treatment yielded consistent results. However, no significant association was observed in the intratympanic corticosteroid subgroup (OR = 0.80; 95% CI, 0.45-1.44). Conclusions: Tinnitus may serve as a favorable prognostic indicator for hearing recovery in SSHL, except in patients receiving intratympanic corticosteroids. Systemic corticosteroids might be more effective for SSHL patients with tinnitus. Future studies could explore personalized SSHL treatment strategies using tinnitus as a stratification criterion.