title: L-N-Acetylcysteine treatment is associated with improved hearing outcome in sudden idiopathic sensorineural hearing loss.
abstract: CONCLUSIONS
  Combination therapy corticosteroids plus an oral antioxidant L-N-acetylcysteine (LNAC) was associated with improved hearing over corticosteroids alone, particularly at the 6-month follow-up and at high frequencies (i.e. 4000 Hz). This is the first report of a beneficial effect of LNAC in sudden idiopathic sensorineural hearing loss (SISNHL).
  
  
  OBJECTIVE
  To determine the association between antioxidant treatment and functional outcomes in SISNHL.
  
  
  METHODS
  This was a case-control study of adult patients with SISNHL, treated with oral prednisone plus intratympanic dexamethasone either alone or in combination with LNAC. The outcome measure was change in pure-tone thresholds at 500-4000 Hz. Hearing recovery was also recorded as the percentage of subjects with final pure-tone threshold average (PTA) within 50% of the difference between the initial value of the affected ear and the value of the unaffected ear. Comparisons were made between combination (corticosteroids plus LNAC) and single (no LNAC use) therapy groups.
  
  
  RESULTS
  At 6 months, the mean PTA improvements were 26.1 dB and 15.1 dB for the combination and single therapy groups, respectively (p = 0.046). Higher gains at 4000 Hz were noted with LNAC use. The percentage of patients with at least 50% recovery was 63% and 35% for the combination and single therapy groups, respectively (p = 0.0319).
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, FL, USA. sangeli@med.miami.edu
authors.forename: Simon I
authors.initials: SI
authors.lastname: Angeli
authors.forename: Ralph N
authors.initials: RN
authors.lastname: Abi-Hachem
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Vivero
authors.forename: Fred T
authors.initials: FT
authors.lastname: Telischi
authors.forename: John J
authors.initials: JJ
authors.lastname: Machado
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D016166:Free Radical Scavengers; D005938:Glucocorticoids; D003907:Dexamethasone; D011241:Prednisone; D000111:Acetylcysteine