title: The effect of initial treatment on hearing prognosis in idiopathic sudden sensorineural hearing loss: a nationwide survey in Japan.
abstract: OBJECTIVE
  To investigate the hearing prognosis of idiopathic sudden sensorineural hearing loss (SSNHL) treated with different initial therapies.
  
  
  METHODS
  Subjects consisted of patients diagnosed with idiopathic SSNHL within 7 days from onset and showing severe hearing loss (≥60 dB), who were registered in a Japanese multicenter database between April 2014 and March 2016. Subjects were divided into four groups according to initial therapy: (1) steroids, (2) steroids + Prostaglandins (PGs), (3) intratympanic steroids (ITS), and (4) no steroids. Hearing outcomes were compared among the groups.
  
  
  RESULTS
  In total, 1305 patients were enrolled. The final hearing level and hearing gain of patients treated with steroids + PGs were significantly higher than those of patients treated with steroids alone or no steroids. The ratio of good prognosis (complete recovery or marked improvement) in patients treated with steroids + PGs was higher than that in patients treated with steroids alone or no steroids. There was no difference in the prognosis of patients treated with steroids alone or no steroids.
  
  
  CONCLUSIONS
  A large number of patients with idiopathic SSNHL were registered in a multicenter database. PG use in combination with steroid administration was associated with a good hearing prognosis in patients with severe hearing loss.
authors.affiliation: a Department of Otolaryngology , Ehime University School of Medicine , Toon , Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okada
authors.affiliation: a Department of Otolaryngology , Ehime University School of Medicine , Toon , Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Hato
authors.affiliation: b Department of Otorhinolaryngology , Shinshu University School of Medicine , Matsumoto , Japan.
authors.forename: Shin-Ya
authors.initials: SY
authors.lastname: Nishio
authors.affiliation: b Department of Otorhinolaryngology , Shinshu University School of Medicine , Matsumoto , Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kitoh
authors.affiliation: c Department of Otorhinolaryngology Head and Neck Surgery , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: c Department of Otorhinolaryngology Head and Neck Surgery , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Kanzaki
authors.affiliation: d Department of Otorhinolaryngology , Nagoya University, Graduate School of Medicine , Nagoya , Japan.
authors.forename: Michihiko
authors.initials: M
authors.lastname: Sone
authors.affiliation: e Department of Otolaryngology-Head and Neck Surgery , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukuda
authors.affiliation: f Department of Otolaryngology, Faculty of Medicine , University of Tsukuba , Tsukuba , Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Hara
authors.affiliation: g Department of Otorhinolaryngology , Saitama School of Medicine , Moroyama , Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ikezono
authors.affiliation: h Department of Otolaryngology, Hospital , National Rehabilitation Center for Persons with Disabilities , Tokorozawa , Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Ishikawa
authors.affiliation: i Department of Otolaryngology , International University of Health and Welfare, Mita Hospital , Tokyo , Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iwasaki
authors.affiliation: j Division of Hearing and Balance Research , National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center , Tokyo , Japan.
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Kaga
authors.affiliation: k Department of Otorhinolaryngology , Yamagata University School of Medicine , Yamagata , Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Kakehata
authors.affiliation: l Department of Otorhinolaryngology , Hirosaki University Graduate School of Medicine , Hirosaki , Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Matsubara
authors.affiliation: j Division of Hearing and Balance Research , National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center , Tokyo , Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Matsunaga
authors.affiliation: m Department of Otolaryngology , Gunma University Graduate School of Medicine , Maebashi , Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Murata
authors.affiliation: n Department of Otolaryngology , Kobe City Medical Center General Hospital , Kobe , Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Naito
authors.affiliation: o Department of Otorhinolaryngology , Kyushu University Graduate School of Medical Sciences , Fukuoka , Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakagawa
authors.affiliation: p Department of Otolaryngology-Head and Neck Surgery , Okayama University Graduate School of Medicine, Dentistry and Pharmacy , Okayama , Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nishizaki
authors.affiliation: b Department of Otorhinolaryngology , Shinshu University School of Medicine , Matsumoto , Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Noguchi
authors.affiliation: q Department of Otolaryngology , Kitasato University School of Medicine , Sagamihara , Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Sano
authors.affiliation: r Department of Otorhinolaryngology , Iwate Medical University , Morioka , Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sato
authors.affiliation: s Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: t Department of Otorhinolaryngology, Head and Neck Surgery , University of Toyama , Toyama , Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Shojaku
authors.affiliation: u Department of Otolaryngology , Nagasaki University Faculty of Medicine , Nagasaki , Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: v Department of Otolaryngology , Okinaka Memorial Institute for Medical Research, Toranomon Hospital , Tokyo , Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Takeda
authors.affiliation: w Department of Otolaryngology, Faculty of Medicine , University of Miyazaki , Miyazaki , Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tono
authors.affiliation: x Department of Otolaryngology , Yamaguchi University Graduate School of Medicine , Ube , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: y Department of Otolaryngology, Faculty of Medicine , University of Tokyo , Tokyo , Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamasoba
authors.affiliation: b Department of Otorhinolaryngology , Shinshu University School of Medicine , Matsumoto , Japan.
authors.forename: Shin-Ichi
authors.initials: SI
authors.lastname: Usami
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011453:Prostaglandins / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D011453:Prostaglandins
keywords: Idiopathic sudden sensorineural hearing; intratympanic steroid injection; prostaglandin; steroid