title: Steroid-based treatments for patients with total sudden sensorineural hearing loss.
abstract: CONCLUSIONS
  In patients with total sudden sensorineural hearing loss (SSNHL), oral prednisone (OP) alone or intratympanic dexamethasone (ITD) alone have comparable results. The addition of salvage ITD following OP does not seem to add over either single modality treatment.
  
  
  OBJECTIVE
  To study the effect of steroid-based treatments in patients with total SSNHL.
  
  
  METHODS
  The medical charts of 59 patients with total loss of hearing, defined as pure tone thresholds in the profound range (> 90 dB) with an unobtainable speech reception threshold (SRT) that were treated with OP (n = 20), ITD (n = 13), or OP followed by salvage ITD (n = 26) were analyzed. Response to treatment was evaluated by means of pure tone thresholds, SRT, and speech discrimination score (SDS), immediately after treatment and on a follow-up visit.
  
  
  RESULTS
  Forty-nine patients (83%) responded to treatment, with mean significant improvements of 36, 34, 31, and 25 dB at 500, 1000, 2000, and 4000 Hz, respectively. The mean improvement in SRT was 33 dB, and SDS improved by 32%. There were no differences in improvement in pure tone thresholds and SRT among the three treatment groups. The late effect of OP was similar to the effect of salvage ITD.
authors: Department of Otolaryngology, Head and Neck Surgery, Sheba Medical Center , Tel Hashomer , Israel.
authors: Gabriel
authors: G
authors: Nakache
authors: Lela
authors: L
authors: Migirov
authors: Sharon
authors: S
authors: Trommer
authors: Michael
authors: M
authors: Drendel
authors: Michael
authors: M
authors: Wolf
authors: Yael
authors: Y
authors: Henkin
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000188:drug therapy*; D006801:Humans; D000069555:Injection, Intratympanic; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome; D014432:Tympanic Membrane
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D011241:Prednisone
keywords: Sudden sensorineural hearing loss; intratympanic dexamethasone; oral prednisone; profound hearing loss; speech discrimination score; speech reception thresholds (SRT); total hearing loss