Efficacy of 3 different steroid treatments for sudden sensorineural hearing loss: a prospective, randomized trial

• Published in: Otolaryngology-head and neck surgery Vol. 148; no. 1; p. 121
• Main Authors: Lim, Hye Jin, Kim, Yun Tae, Choi, Seong Jun, Lee, Jong Bin, Park, Hun Yi, Park, Keehyun, Choung, Yun-Hoon
• Format: Journal Article
• Language: English
• Published: England 01.01.2013
• Subjects: Administration, Oral; Adult; Aged; Aged, 80 and over; Ambulatory Care - methods; Audiometry, Pure-Tone; Dexamethasone - administration & dosage; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Hearing Loss, Sensorineural - diagnosis; Hearing Loss, Sensorineural - drug therapy; Hearing Loss, Sudden - diagnosis; Hearing Loss, Sudden - drug therapy; Humans; Injections, Intralesional; Male; Middle Aged; Prednisolone - administration & dosage; Prospective Studies; Recovery of Function; Reference Values; Severity of Illness Index; Tertiary Care Centers; Treatment Outcome; Tympanic Membrane - drug effects; Young Adult
• ISSN: 1097-6817
• DOI: 10.1177/0194599812464475

We treated patients with idiopathic sudden sensorineural hearing loss (ISSNHL) with several protocols on an outpatient department (OPD) basis. The study compared the efficacy of 3 different steroid treatments for ISSNHL. A prospective randomized controlled study. Tertiary referral center. A total of 60 patients diagnosed with ISSNHL were treated through OPD. They were randomly and equally divided into 3 groups based on therapy: oral steroid for 10 days (group I), intratympanic dexamethasone injection (ITDI) 4 times (group II), and both (group III). Pure-tone average (PTA) was measured by taking 4 frequencies (0.5, 1, 2, and 3 kHz). Hearing change was evaluated by comparing pre- and posttreatment PTAs. Recovery rate was assessed by American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Clinical Practice Guidelines. The hearing gain was 12.8 ± 15.4 decibels (dB) in group I, 12.1 ± 14.6 dB in group II, and 21.9 ± 26.2 dB in group III. The recovery rate was 60% in groups I and III and 55% in group II. The overall recovery rate was 58.3% (35 of 60 patients). There was no significant difference in hearing gain and recovery rates for the 3 groups. Frequency-specific hearing gain also did not differ significantly among groups. Three different treatment protocols (oral steroid, ITDI, or the combination) resulted in similar hearing recovery rates. Therefore, OPD-based systemic and/or local steroid therapy can be recommended as an initial treatment in ISSNHL.