Acupuncture Therapy for Sudden Sensorineural Hearing Loss

• Acupuncture (Procedure): Main Acupoints (Fixed): Tinghui (GB2), Yifeng (SJ17), Tinggong (SI19), and Shuaigu (GB8) on the affected side; Baihui (GV20) at the vertex; Zhongzhu (SJ3) and Zulinqi (GB41) bilaterally. Adjunct Acupoints (Bilateral, selected based on TCM pattern differentiation): External Pathogen Invasion: Hegu (LI4) + Waiguan (SJ5) Liver Fire Harassing Upper: Yanglingquan (GB34) + Xingjian (LR2) Phlegm Fire Stagnation: Fenglong (ST40) + Neiting (ST44) Qi Stagnation and Blood Stasis: Xuehai (SP10) + Taichong (LR3) Kidney Essence Deficiency: Taixi (KI3) + Sanyinjiao (SP6) Spleen and Stomach Deficiency: Zusanli (ST36) + Qihai (CV6)
• Sham acupuncture (Procedure): The same acupoints are used, but with blunt-tip placebo needles that do not penetrate the skin. The needles are fixed with adhesive patches, and the procedure is identical to the real acupuncture group to maintain blinding.

Primary outcomes

• Hearing improvement [Week 8]: Hearing improvement measured by the change in Pure Tone Audiometry (PTA) average (500, 1000, 2000, and 4000 Hz) from baseline to week 8, compared between the acupuncture + corticosteroid group and the sham acupuncture + corticosteroid group.

Secondary outcomes

• Hearing outcomes at multiple time points [week 1, 2, 4, 8, and 12]: Changes in PTA at weeks 1, 2, 4, 8, and 12
• Word Recognition Score (WRS) [weeks 1, 2, 4, 8, and 12]: Changes of WRS from baseline at weeks 1, 2, 4, 8, and 12
• Sudden hearing loss recovery grade [weeks 1, 2, 4, 8, and 12]: Complete, significant, partial, or no recovery according to the 2019 AAO-HNS guideline criteria
• TCM symptom score [week 8]: Change from baseline to week 8 using the pattern-specific TCM symptom scale
• Sensory Organization Test [weeks 1, 2, 4, 8, and 12]: Sensory Organization Test (SOT) scores at weeks 1, 2, 4, 8, and 12
• Insomnia Severity Index (ISI) [weeks 1, 2, 4, 8, and 12]: Changes from baseline at weeks 1, 2, 4, 8, and 12
• Dizziness Handicap Inventory (DHI) [weeks 1, 2, 4, 8, and 12]: Changes from baseline at weeks 1, 2, 4, 8, and 12
• Tinnitus Handicap Inventory (THI) [weeks 1, 2, 4, 8, and 12]: Changes from baseline at weeks 1, 2, 4, 8, and 12
• Hospital Anxiety and Depression Scale (HADS) [weeks 1, 2, 4, 8, and 12]: Changes from baseline at weeks 1, 2, 4, 8, and 12
• Quality of life (SF-36) [weeks 1, 2, 4, 8, and 12]: Changes from baseline at weeks 1, 2, 4, 8, and 12
• Aural fullness scale (AFS) [weeks 1, 2, 4, 8, and 12]: Visual analog scale (0-10) changes from baseline at weeks 1, 2, 4, 8, and 12
• Salvage treatment rate [day 14]: Proportion of participants requiring intratympanic steroid injection due to insufficient hearing recovery at day 14
• Safety outcome [week 8]: Proportion of adverse events in both groups at week 8

Sex: All, ages: 18 Years to 70 Years

Inclusion Criteria:

* Age between 18 and 70 years;
* Meets the diagnostic criteria for sudden sensorineural hearing loss (SSNHL): sudden, unexplained sensorineural hearing loss occurring within 72 hours, with a hearing threshold decrease of ≥30 dB in at least three consecutive frequencies among 250, 500, 1000, 2000, 4000, and 8000 Hz (reference: previous audiologic examination or same frequencies of the contralateral ear);
* Unilateral SSNHL with self-perceived symmetrical hearing in both ears prior to the current episode (or supported by previous audiologic examination reports);
* Time from symptom onset to enrollment and treatment initiation within 14 days;
* Clear consciousness and logical responses, able to understand the scale items and complete the assessments;
* Agrees to participate in the trial and signs a written informed consent form.

Exclusion Criteria:

* Identifiable definite etiology after complete examination, including acoustic neuroma, cerebrovascular accident, trauma, Hunt syndrome, etc.;
* History of hearing abnormality (affected ear) or balance dysfunction prior to the current episode (including previous SSNHL, vestibular migraine, Meniere's disease, benign paroxysmal positional vertigo, congenital/hereditary/syphilitic hearing loss, otosclerosis, etc.);
* Presence of diseases for which systemic corticosteroid therapy is clinically not recommended (e.g., poorly controlled or insulin-dependent diabetes mellitus, history of peptic ulcer, active infection or tuberculosis, history of hepatitis B or C, pancreatitis, severe osteoporosis, osteonecrosis, etc.);
* Received systemic or local corticosteroid therapy for 10 days or more prior to enrollment;
* Presence of other diseases (e.g., severe skin disorders) that preclude completion of acupuncture treatment;
* Presence of severe organ dysfunction;
* Received acupuncture treatment within the past 12 months;
* Pregnant or breastfeeding women;
* Other reasons deemed by the investigator as unsuitable for participation in this clinical study (e.g., high anticipated difficulty in completing follow-up, obvious low compliance, etc.).