The efficacy of corticosteroids in restoring hearing in patients undergoing conservative management of acoustic neuromas.
OBJECTIVE
To evaluate the role of corticosteroids in restoring hearing in patients undergoing conservative management of acoustic neuromas.


METHODS
Prospective cohort.


METHODS
Tertiary referral center.


METHODS
Seven patients with acute hearing loss secondary to an acoustic neuroma.


METHODS
Oral prednisone (1 mg/kg for 1 to 2 weeks) within a week of onset of hearing loss.


METHODS
Audiometric assessment at the time of presentation and after corticosteroid therapy.


RESULTS
All seven patients had pure tone reception threshold improvements ranging from 10 to 50 dB in at least two frequencies or more. Speech discrimination thresholds improved after therapy in all seven patients, with gains of 4 to 38% points.


CONCLUSIONS
Patients with acoustic neuromas who are being treated with a "watchful waiting" approach should receive corticosteroid treatment at the first signs of hearing deterioration. An evaluation to rule out a retrocochlear lesion is mandated in patients with sudden hearing loss, regardless of whether the hearing loss responds to corticosteroid treatment. Older data documenting the efficacy of corticosteroids in the treatment of sudden hearing loss may need to be reevaluated, given that many of these studies were conducted before MRI was available.
Aronzon
Anna
A
Department of Otolaryngology and Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA.
Ruckenstein
Michael J
MJ
Bigelow
Douglas C
DC
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications* / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D011241:Prednisone