Efficacy of 3 different steroid treatments for sudden sensorineural hearing loss: a prospective, randomized trial.
Lim, HJ; Kim, YT; Choi, SJ; Lee, JB; Park, HY; Park, K; Choung, YH
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 148(1):121-127, 2013
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
OBJECTIVES: 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.
STUDY DESIGN: A prospective randomized controlled study.
SETTING: Tertiary referral center.
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.
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