Efficacy of 3 different steroid treatments for sudden sensorineural hearing loss: a prospective, randomized trial.
OBJECTIVE
We treated patients with idiopathic sudden sensorineural hearing loss (ISSNHL) with several protocols on an outpatient department (OPD) basis. The study compared the efficacy of 3 different steroid treatments for ISSNHL.


METHODS
A prospective randomized controlled study.


METHODS
Tertiary referral center.


METHODS
A total of 60 patients diagnosed with ISSNHL were treated through OPD. They were randomly and equally divided into 3 groups based on therapy: oral steroid for 10 days (group I), intratympanic dexamethasone injection (ITDI) 4 times (group II), and both (group III). Pure-tone average (PTA) was measured by taking 4 frequencies (0.5, 1, 2, and 3 kHz). Hearing change was evaluated by comparing pre- and posttreatment PTAs. Recovery rate was assessed by American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Clinical Practice Guidelines.


RESULTS
The hearing gain was 12.8 ± 15.4 decibels (dB) in group I, 12.1 ± 14.6 dB in group II, and 21.9 ± 26.2 dB in group III. The recovery rate was 60% in groups I and III and 55% in group II. The overall recovery rate was 58.3% (35 of 60 patients). There was no significant difference in hearing gain and recovery rates for the 3 groups. Frequency-specific hearing gain also did not differ significantly among groups.


CONCLUSIONS
Three different treatment protocols (oral steroid, ITDI, or the combination) resulted in similar hearing recovery rates. Therefore, OPD-based systemic and/or local steroid therapy can be recommended as an initial treatment in ISSNHL.
Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea.
Hye Jin
HJ
Lim
Yun Tae
YT
Kim
Seong Jun
SJ
Choi
Jong Bin
JB
Lee
Hun Yi
HY
Park
Keehyun
K
Park
Yun-Hoon
YH
Choung
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage*; D011446:Prospective Studies; D020127:Recovery of Function; D012016:Reference Values; D012720:Severity of Illness Index; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000187:drug effects; D055815:Young Adult
D003907:Dexamethasone; D011239:Prednisolone