Sudden sensorineural hearing loss: does application of glucocorticoids make sense?
BACKGROUND
Treatment of sudden sensorineural hearing loss (SSNHL) consists of administration of blood flow-promoting drugs with or without the addition of glucocorticoids. General guidelines based on scientific data do not currently exist.


OBJECTIVE
To investigate the effect of glucocorticoids on the treatment of SSNHL.


METHODS
Academic medical center.


METHODS
We retrospectively analyzed the audiograms of 603 patients with SSNHL: 301 patients (cared for between January 1, 1986, and December 31, 1991) received intravenous blood flow-promoting drugs without glucocorticoids and 302 patients (cared for between January 1, 1992, and December 31, 1998) received intravenous blood flow-promoting drugs with glucocorticoids (intravenous +/- oral application). The age distribution of patients with SSNHL in lower, middle, and higher frequencies was similar in both groups.


RESULTS
Patients with SSNHL in lower and middle frequencies (250-2000 Hz) who received glucocorticoids (prednisolone-21-hydrogen-succinate) showed significantly better recovery of hearing levels compared with those who did not receive glucocorticoids (P<.05). There was no significant difference at higher frequencies between the 2 groups. Patients with SSNHL throughout all frequencies (pancochlear hearing loss) who received glucocorticoids also had significantly better recovery of hearing levels compared with those who received blood flow-promoting drugs alone (P<.05). Also, patients with elevated blood sedimentation rates had better improvement of their hearing levels after receiving glucocorticoids.


CONCLUSIONS
Administration of glucocorticoids should be recommended for treatment of patients with SSNHL. In particular, patients with SSNHL in the lower and middle frequency range and pancochlear hearing loss have significantly better recovery of hearing levels.
Alexiou
C
C
Klinikum rechts der Isar, Hals-Nasen-Ohren Klinik und Poliklinik, Ismaningerstr. 22, 81675 München, Germany. C.Alexiou@lrz.tu-muenchen.de
Arnold
W
W
Fauser
C
C
Schratzenstaller
B
B
Gloddek
B
B
Fuhrmann
S
S
Lamm
K
K
D000328:Adult; D001301:Audiometry, Pure-Tone; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012189:Retrospective Studies
D005938:Glucocorticoids