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Concierge ENT · United Kingdom

Intratympanic steroid injection, by a consultant ENT surgeon.

A minimally invasive alternative — or partner — to oral steroids for sudden sensorineural hearing loss and Ménière’s disease. A high inner-ear dose, tiny systemic exposure, and the 14-day window taken seriously.

See indicative pricing
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Why patients choose us

  • 01

    A consultant ENT surgeon, in clinic

    Not a nurse-led add-on and not a hurried follow-up. A named otologist, a proper microscope, and enough time to do it well.

  • 02

    The 14-day window taken seriously

    For sudden sensorineural hearing loss the NICE window is short. We book you inside it, not behind it.

  • 03

    Independent, and free

    We are paid by no clinic, so the recommendation is impartial and costs you nothing.

Indicative pricing

What a private intratympanic steroid injection costs in the UK.

Indicative ranges across our partner ENT clinics. Send the details and we quote firm figures across two or three options.

In short

A single IT steroid injection in our network: £250–£500, home the same day.

Procedure Indicative range
Single IT steroid injection (dexamethasone) £250–£500
Single IT injection (methylprednisolone) £300–£550
Full SSNHL salvage course (3–4 injections) £900–£1,800
Ménière’s IT steroid course (1–3 injections) £500–£1,400
IT gentamicin (chemical labyrinthectomy) £350–£700
ENT consultation and audiogram only £250–£450

Prices vary by clinic, by which ENT surgeon delivers the injection, by drug choice, and by whether a full salvage course or a single injection is planned. We come back with a firm quote within one working day.

The problem

The right drug, the right ear, and the right week.

Sudden hearing loss is quietly one of the worst-triaged conditions in UK medicine — GP delays, mislabelling as wax, and lost weeks. We compress the timeline and put you in front of an otologist inside the window.

  • Sudden hearing loss?

    The two-week window is real. We book you inside it, not behind it.

  • Ménière’s flaring?

    A short IT steroid course can quieten attacks without ablating your balance.

  • Oral steroids not safe?

    IT delivery gives the inner ear a higher dose with tiny systemic exposure — better for diabetes, glaucoma and pregnancy.

The journey

From enquiry to end of course — what happens, in order.

One clinician from first message to the review audiogram — including the injections in between.

  1. 01

    Before

    You tell us what is going on

    A short, confidential form. Sudden hearing loss, Ménière’s attacks, tinnitus flare, and — crucially — when it started.

  2. 02

    Before

    We come back with a recommendation

    Within one working day: the right ENT surgeon, drug (dexamethasone or methylprednisolone), regimen, and an indicative price. If oral steroids first is the better call, we say so.

  3. 03

    Before

    We arrange the appointment

    For sudden hearing loss usually within 48–72 hours. Anticoagulants are reviewed with the team, and you are told exactly how to prepare.

  4. 04

    On the day

    Arrival at the clinic

    A brief consent chat, an otoscopic check, and topical anaesthetic on the eardrum — either phenol under the microscope or EMLA cream for 30 minutes.

  5. 05

    On the day

    The injection itself

    Two to three minutes under the microscope. A fine needle through the anterosuperior eardrum; 0.4–0.6 ml of steroid delivered against the round window.

  6. 06

    On the day

    Head-turned rest, then home

    Fifteen to thirty minutes lying with the treated ear up, then straight home. Total appointment: 30–45 minutes.

  7. 07

    After

    The course and review

    Typically three to four injections over one to two weeks for sudden hearing loss; a shorter course for Ménière’s. A pure-tone audiogram at the end of the course.

Typical end-to-end: 2–3 days from enquiry to first injection. Full salvage course: 1–2 weeks.

When it helps

When an intratympanic steroid injection is the right step.

The situations we see most, plus the one red flag that means an emergency rather than an appointment.

  • Sudden sensorineural hearing loss

    A drop in hearing in one ear over hours to three days — a medical urgency, best treated inside 14 days per NICE IPG675.

  • Ménière’s disease

    Recurrent vertigo attacks with fluctuating hearing and tinnitus — IT steroids can quieten attacks without ablating balance.

  • Salvage after oral steroids

    For partial or absent recovery after a course of oral prednisolone — IT steroids can rescue a portion of hearing.

  • Oral steroids contraindicated

    For patients with diabetes, brittle mood, glaucoma or peptic ulcer, IT delivery gives high inner-ear dose with tiny systemic exposure.

  • Autoimmune inner ear disease

    A rarer cause of fluctuating bilateral hearing loss — IT steroids are used alongside systemic immunosuppression.

  • Cochlear-implant hearing preservation

    Increasingly given at implantation to protect residual low-frequency hearing.

  • Refractory tinnitus (selected)

    Evidence is limited but occasional trial is reasonable in disabling, one-sided tinnitus with an inner-ear cause.

  • Red flag: sudden hearing loss now

    A sudden drop in hearing in one ear is a medical urgency — same-week ENT, not a routine appointment.

Injection options

Drug, dose and regimen — what is on the table.

What each option actually involves — and which fits which problem.

  • Dexamethasone 24 mg/ml

    The commonest UK choice — a small volume, well-tolerated, and easy to repeat two to four times over a fortnight.

  • Methylprednisolone 40 mg/ml

    A longer-acting steroid preferred by some centres, particularly for Ménière’s disease.

  • Primary IT (oral steroids CI)

    First-line IT when systemic steroids are unsafe — diabetes, glaucoma, mood disorders, ulcer disease, pregnancy.

  • Combined oral plus IT

    Given together for severe or profound sudden hearing loss — some evidence this outperforms either alone.

  • Salvage IT after oral course

    Given after a course of oral prednisolone has failed to restore hearing — the classic UK indication.

  • Ménière’s maintenance course

    A short course of one to three injections at intervals, aimed at reducing vertigo attacks while sparing balance.

  • IT gentamicin (labyrinthectomy)

    A different drug for medication-refractory Ménière’s — deliberately ototoxic, ablates ipsilateral balance in exchange for vertigo control.

  • Audiogram-guided review

    Pure-tone audiogram before, during and after the course — the only honest way to judge whether the treatment is working.

Our vetted UK network

A small panel of otologists, we picked them.

Consultant ENT surgeons with an otology sub-specialism, across London and the main UK cities. Not listed publicly — introductions are made privately, once we understand your case.

Selection criteria

How we choose every ENT surgeon in our network.

A modern UK ENT outpatient clinic set up for intratympanic injection
Consultant-led otology
  • Consultant otologists and neurotologists, not general ENT trainees

  • Microscope-based delivery, not blind bedside injection

  • Access within days for sudden sensorineural hearing loss

  • Formal pure-tone audiometry before and after every course

Safety and recovery

What to expect afterwards — honestly.

Intratympanic steroid is a common, safe outpatient injection. The things worth planning for are a few hours of dizziness, a possible pinhole perforation, and getting the timing right.

  • Transient dizziness is universal

    Cold liquid against the round window makes the room spin for a few minutes to a couple of hours. Expected, not a complication.

  • A brief tinnitus flare is common

    A short-lived rise in tinnitus for a day or two after the injection is normal. It usually settles as the hearing does.

  • Taste changes are usually temporary

    A metallic taste on one side of the tongue can occur if the chorda tympani nerve is grazed. It almost always resolves in weeks.

  • Eardrum perforation in 5–10%

    A pinhole perforation from the injection site — most close by themselves within six to eight weeks; a few need a small patch procedure.

  • Steroid is not ototoxic

    Dexamethasone and methylprednisolone do not damage hearing. Gentamicin, used only for Ménière’s labyrinthectomy, is deliberately ototoxic.

  • Middle-ear infection is rare

    A small risk of otitis media or discharge from the ear afterwards. Antibiotic drops sort out almost all cases.

  • Time matters for sudden hearing loss

    The best hearing outcomes come from treatment inside the first two weeks. After six weeks the odds of recovery fall sharply.

  • Ménière’s: steroid before gentamicin

    IT steroid preserves balance. IT gentamicin destroys it on the treated side — a reasonable trade only when steroid and medication have failed.

  • Red flags

    Fever, discharge, sudden further hearing drop or severe pain after the injection are not normal — call the clinic or A&E the same day.

Reading your clinic letter

Your ENT letter in four parts. Read the last one first.

Whichever drug and regimen was used, the letter the ENT surgeon sends you keeps to the same shape.

A UK consultant ENT surgeon reviewing an audiogram before an intratympanic injection

A quiet reminder

Audiology language is precise and can read coldly — we translate it for you.

If you would like us to talk you through the audiogram before your review, just ask.

  1. 01 Header

    Indication, ear, and drug used

    Why the injection was done — sudden hearing loss, Ménière’s, salvage — plus which ear, which steroid, and the dose.

  2. 02 Technique

    Anaesthetic and injection technique

    Whether phenol, EMLA or injectable LA was used, the eardrum quadrant entered, and the volume delivered.

  3. 03 Findings

    Audiogram and vestibular notes

    Pure-tone thresholds before and after the course, tympanogram, and any change in vertigo or tinnitus scores.

  4. 04 Impression

    Response, next steps, review timing

    Read this first: whether hearing or vertigo improved, whether further injections are planned, and when to be seen again.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for intratympanic steroid injection varies by insurer — usually funded when medically indicated for sudden hearing loss or Ménière’s. We confirm cover before booking.

Frequently asked

Everything we get asked about intratympanic steroid injection.

Quick answers on pain, cost, the NICE window, and how it differs from gentamicin.

  • What is an intratympanic steroid injection?

    A small injection of steroid — usually dexamethasone or methylprednisolone — through the eardrum into the middle ear. From there it diffuses across the round window into the inner ear, giving a far higher local dose than oral steroids can safely achieve.

  • Why has my ENT surgeon suggested it for sudden hearing loss?

    NICE interventional procedures guidance IPG675 (2020) supports intratympanic steroids for sudden sensorineural hearing loss — as primary treatment when oral steroids are contraindicated, or as salvage when oral steroids have not fully worked. The best results are seen when treatment starts within 14 days of the hearing dropping.

  • How does it help Ménière’s disease?

    A short course of intratympanic steroid can reduce the frequency and severity of vertigo attacks — with, in most series, 60–80% good vertigo control at a year, and without ablating balance the way gentamicin does.

  • Does the injection hurt?

    The eardrum is numbed beforehand — either with a drop of phenol under the microscope or an EMLA cream soak for around 30 minutes. The injection itself is usually a brief pressure sensation rather than sharp pain, and takes only a couple of minutes.

  • How much does it cost privately in the UK?

    Roughly £250–£500 for a single injection, or £900–£1,800 for a full salvage course of three to four injections over a fortnight, including audiogram. We confirm a firm figure within one working day.

  • How many injections will I need?

    For sudden sensorineural hearing loss, three or four spaced over one to two weeks is typical. For Ménière’s, one to three at intervals is usual. The audiogram guides the plan.

  • What is the difference between intratympanic steroid and intratympanic gentamicin?

    Steroid is anti-inflammatory and does not damage hearing or balance. Gentamicin is deliberately ototoxic — it destroys the balance organ on the treated side to stop refractory Ménière’s vertigo, at the cost of ipsilateral vestibular function. They are different treatments for different patients.

  • Can I drive home afterwards?

    Most people can, but you may feel briefly dizzy or unbalanced for up to a couple of hours. If it is your first injection, or you know you react strongly, arrange a lift for peace of mind.

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