Therapeutic effect of combined steroid–lipoprostaglandin E1 for sudden hearing loss: a propensity score-matched analysis

• Published in: American journal of otolaryngology Vol. 36; no. 1; pp. 52 - 56
• Main Authors: Lee, Ho Yun, MD, PhD, Kim, Ji Chan, MD, Choi, Myoung Su, MD, Chang, Dong-Sik, MD, Kim, Ah-Young, MD, PhD, Cho, Chin Saeng, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2015; Elsevier Limited
• Subjects: Age; Alprostadil - therapeutic use; Audiometry, Pure-Tone; Confidence intervals; Dexamethasone - administration & dosage; Dexamethasone - therapeutic use; Diabetes; Drug Synergism; Female; Glucocorticoids - administration & dosage; Glucocorticoids - therapeutic use; Hearing aids; Hearing loss; Hearing Loss, Sudden - drug therapy; Humans; Hypertension; Male; Methylprednisolone - administration & dosage; Methylprednisolone - therapeutic use; Middle Aged; Otolaryngology; Propensity Score; Prospective Studies; Sensitivity and Specificity; Surgery; Treatment Outcome; Vasodilator Agents - therapeutic use
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2014.10.007

Abstract Objectives The aim of this study is to analyze the synergistic effect of combined steroid–lipoprostaglandin E1 for the treatment of sudden hearing loss. Methods A prospective observational, non-randomized study with a historical cohort was performed at a university hospital. Between 2005 and 2012, 421 patients with idiopathic sudden sensorineural hearing loss were enrolled in this study and treated with combined steroid–lipoprostaglandin E1 treatment. Additionally, 132 patients were prospectively enrolled and treated with steroid treatment alone between January 2013 and March 2014. After performing a propensity score-matched analysis, final hearing levels and the degree of recovery were compared according to treatment options. Results A total of 240 patients were enrolled after propensity score-matching, with 180 patients classified as combined steroid–lipoprostaglandin E1 treatment group (group I) and 60 patients as steroid treatment alone group (group II). The final hearing level (35.56 ± 34.64 dB) in group I was not significantly different from that in group II (34.64 ± 24.67 dB) ( p < 0.05). Logistic regression analysis revealed that the combined treatment did not influence recovery, and the probability of recovery was 1.881 times higher in the absence of dizziness (95% confidence interval: 1.022–3.464, p = 0.042), and 1.026 times higher in patients with better hearing in healthy ears (95% confidence interval: 1.010–1.041, p = 0.001). Conclusion Compared to steroid treatment alone, combined steroid–lipoprostaglandin E1 treatment failed to improve sudden hearing loss.