A meta-analysis reviewed 20 studies comparing the use of placebo, hormonal, and antiviral treatments, and other active treatments, as well as intra-dural injection of dexamethasone for idiopathic sensorineural deafness. Although the treatments used varied considerably, the common thread of these studies used pure-tone audiometric thresholds, mean pure-tone thresholds, and/or speech recognition scores as indicators of efficacy in monitoring hearing recovery. There are various definitions of recovery. The classic classification of recovery is as follows: a. Complete recovery: the mean pure tone threshold and/or speech recognition score improves to within 10 dB of the pre-sudden deafness level; b. Partial recovery: the mean pure tone threshold and/or speech recognition score improves to 50% of the pre-sudden deafness level; c. No recovery: the mean pure tone threshold and/or speech recognition score improves to less than 50% of the pre-sudden deafness level. Other methods of classifying recovery were proposed 30 years later and were offered to clinicians by investigators who had performed intra-drum hormone injections after a review of 25 articles in the literature. The recovery was classified as: a. 10-30 dB improvement in mean pure tone threshold over pre-treatment hearing: no measurement of speech recognition. Using a change in mean pure tone threshold of 10 dB HL to define this is inaccurate because changes in this range of mean pure tone thresholds are within the range of repeated test confidence for tests of pure tone audiometric thresholds. b. A 10-30 dB increase in mean pure tone threshold over pretreatment hearing and a 10-20% increase in speech recognition: It is inaccurate to use a combined consideration of a 10-20% change in word recognition score, as described in the next section. c. The average pure tone threshold (dB HL) of the individual was measured to determine in which range the improvement in hearing fell in terms of complete recovery, partial recovery, or no recovery. 1. Complete recovery: the mean pure tone threshold is restored to within 10 dB of the pre-sudden deafness or healthy ear; 2. Partial recovery: the mean pure tone threshold is restored to within 50% of the pre-sudden deafness or healthy ear, or improved by 10 dB; 3. No recovery: the mean pure tone threshold is restored to less than 10 dB of the pre-sudden deafness; d. The difference between the treated and untreated ear is 50%; e. Speech f. Hearing is within the normal range, and daily communication is possible. When comparing the follow-up hearing with the initial hearing, the change must be 10 dB or more to be meaningful for comparison. When it is necessary to determine whether there is a significant change in speech recognition, the physician should refer to a two-division scale to compare the post-treatment and initial recognition scores. For example, if the initial word recognition score is 20% as measured using a 5O-word word list, it must be more than 36% to be a significant increase and must be less than 8% to be a significant decrease (p>.05). The physician may also choose another approach by going to the materials manual to determine if the difference between the initial and retest results exceeds the 95% confidence interval or some other statistical method. Finally, the physician should document the patient’s post-treatment changes with respect to subjective hearing, tinnitus, fullness in the ear, vertigo, and nausea and vomiting.