The Comparison of Hearing Recovery of Sudden Deafness Treated with Different Protocols

Abstract

Background and Objectives：Sudden hearing loss is not rare, but its pathophysiology has not been fully determined, and treatment is controversial at present. Its etiology is not verified yet, but viral infection, vascular compromise, intracochlear membrane rupture, immune inner ear disease, and tumor are considered as possible causes of disease. The purpose of this study was to analyze the treatment results of sudden hearing loss according to different protocols prospectively, and to provide the basic data for the treatment of sudden hearing loss.

Materials and Methods：Two hundred seventy-three patients who visited Department of Otolaryngology in Ajou University Hospital from June, 1994 to Feb., 2002 were classified to 5 groups according to treatment protocols. We applied different protocols using steroid and heparin in group I (85 ears), steroid, laser, and Tanamin® in group II (51 ears), steroid, Tanamin® in group III (38 ears), steroid, Tanamin®, Vacrax®, Dichlozid® in group IV (44 ears). Group V was treated as control (55 ears) just using steroid without admission. The treatment effects of different protocols were analyzed according to the factors relating to the prognosis. We used Siegel's classification for evaluation of hearing recovery.

Results：Total recovery rate of sudden deafness was 56.4%. There was no difference of hearing improvement among the different protocols. The effectiveness of several combined therapies was similar to that of group using steroid alone therapy. Prognostic factors such as severity of initial hearing loss, age (40 years), duration from disease onset to treatment (7 days) were related to prognosis. However, there was no difference of hearing improvement among the different protocols relating prognostic factors.

Conclusion：There was no single treatment of choice for sudden hearing loss. Although there are many treatment regimens for sudden hearing loss, the rationale behind the therapy should be understood, which is directed toward the most likely causes and patient's condition.