Treatment outcome of additional dextran to corticosteroid therapy on sudden deafness: propensity score-matched cohort analysis.
OBJECTIVE
This study aimed to investigate whether adding low-molecular-weight dextran to oral steroids in patients with idiopathic sudden sensorineural hearing loss resulted in better hearing outcomes than those in patients receiving oral corticosteroids alone.


METHODS
Historical cohort study.


METHODS
Tertiary teaching hospital.


METHODS
The authors reviewed the clinical records of 166 patients with idiopathic sudden sensorineural hearing loss. Therapeutic effectiveness was measured by the gain of pure-tone averages and 4 categories of hearing outcome (complete recovery, marked recovery, mild improvement, or no improvement). To manage potential confounding factors associated with treatment allocation, the authors matched the subjects from each group according to the propensity score (ie, the predicted probability that they would receive a specific treatment).


RESULTS
The authors identified 50 pairs of propensity score-matched subjects (n = 100) without significant difference of all clinical factors (P > .05). Subsequent analyses demonstrated that the average hearing gain in subjects receiving additional dextran to oral steroid was 31.7 ± 21.5 dB, which did not differ from 33.0 ± 21.8 dB in subjects receiving steroids alone (P = .76). Difference of hearing outcomes between the 2 groups was also nonsignificant (P = .92).


CONCLUSIONS
Matching propensity scores successfully balanced the heterogeneity between the dextran and steroid groups. Analytical results demonstrated that adding low-molecular-weight dextran to oral corticosteroids was not associated with greater hearing gain or better hearing outcome in idiopathic sudden sensorineural hearing loss.
Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.
Chi-Te
CT
Wang
Hsu-Wen
HW
Chou
Kai-Min
KM
Fang
Mei-Shu
MS
Lai
Po-Wen
PW
Cheng
D000368:Aged; D001301:Audiometry, Pure-Tone; D016022:Case-Control Studies; D015331:Cohort Studies; D003911:Dextrans / Q000008:administration & dosage* / Q000737:chemistry; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy* / Q000209:etiology; D003639:Hearing Loss, Sudden / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D011239:Prednisolone / Q000008:administration & dosage*; D011336:Probability; D020127:Recovery of Function
D003911:Dextrans; D005938:Glucocorticoids; D011239:Prednisolone