Effect of single-drug treatment on idiopathic sudden sensorineural hearing loss.
OBJECTIVE
In order to evaluate the effect of a medical administration for the sudden deafness patients, single-drug treatment for idiopathic sudden sensorineural hearing loss (ISSHL) was assessed at multi-centers participating in the Acute Severe Hearing Loss Study Group sponsored by the Ministry of Health, Labor and Welfare of Japan.


METHODS
The subjects consisted of ISSHL patients who were (1) 20 years of age or older, (2) diagnosed within 2 weeks after the onset of hearing loss, (3) showing a mean hearing level of 40-90 dB at five frequencies from 250 to 4000 Hz, (4) previously untreated, and (5) with normal for age in hearing of the opposite ear. The drugs used in this study were ATP, alprostadil, hydrocortisone and amidotrizoate, which were administered intravenously, and beraprost sodium and betamethasone, which were given orally. Two drugs were assigned to each center, one of which was selected according to the code hidden in envelopes and administered for 1 week. The treatment after the single-drug administration was conducted at the discretion of each center. The hearing gain and recovery rate at 1 week after the initiation of single-drug treatment and at 1 month or over when the hearing level was fixed, were evaluated based on the criteria for hearing recovery prepared by the Acute Severe Hearing Loss Study Group.


RESULTS
There was no statistically significant difference in the recovery rate among drugs either at 1 week after the initiation of single-drug treatment or at the time of fixed hearing level. At the time when the hearing level was fixed, a statistically significant difference in the complete recovery rate was detected only between amidotrizoate and beraprost sodium.


CONCLUSIONS
From these results, we could not find any specific drugs recommended for ISSNHL. In evaluating the effect of the drugs, however, several problems in the clinical trial for ISSHL should be considered.
Kanzaki
Jin
J
Department of Otolaryngology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Inoue
Yasuhiro
Y
Ogawa
Kaoru
K
Fukuda
Satoshi
S
Fukushima
Kunihiro
K
Gyo
Kiyofumi
K
Yanagihara
Naoaki
N
Hoshino
Tomoyuki
T
Ishitoya
Jun-ichi
J
Toriyama
Minoru
M
Kitamura
Ken
K
Murai
Kazuo
K
Nakashima
Tsutomu
T
Niwa
Hideto
H
Nomura
Yasuya
Y
Kobayashi
Hitome
H
Oda
Makoto
M
Okamoto
Makito
M
Shitara
Tetuya
T
Sakagami
Masafumi
M
Tono
Tetsuya
T
Usami
Shin-ichi
S
D000255:Adenosine Triphosphate / Q000008:administration & dosage; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000008:administration & dosage; D001623:Betamethasone / Q000008:administration & dosage; D003973:Diatrizoate / Q000008:administration & dosage; D011464:Epoprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D007275:Injections, Intravenous; D008875:Middle Aged; D016896:Treatment Outcome
D003973:Diatrizoate; C048081:beraprost; D000255:Adenosine Triphosphate; D001623:Betamethasone; D011464:Epoprostenol; D000527:Alprostadil; D006854:Hydrocortisone