Comparison among Three Different Steroid Therapies for Idiopathic Sudden Sensorineural Hearing Loss
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Background and Objectives The optimal dose or type of systemic steroid for treating idiopathicsudden sensorineural hearing loss (ISSNHL) is unclear. Herein, we compare the efficacyof three steroid treatment protocols. Subjects and Method We reviewed the medical records of 140 adult ISSNHL patients froma tertiary medical center. The patients were divided into three groups based on their treatmentregimen: Group 1 received intravenous 10 mg/day dexamethasone combined with intratympanic(IT) steroid injection, followed by prednisolone for 5 days after discharge; Group 2 received 10mg/day dexamethasone for 5 days, followed by 5 mg/day for 5 days over a 10-day hospitalizationperiod; and Group 3 received 10 mg/day dexamethasone combined with IT steroid injectionduring a 5-day hospital stay, followed by 5 mg/day dexamethasone for 5 days after discharge. The hearing thresholds were measured using an automatic audiometer at 0.5, 1, 2, 3, 4, and 8kHz. Hearing recovery on Day 90 was categorized according to Siegel’s criteria. Results Univariate and multivariate analyses showed that patients in Group 3 had the lowesthearing thresholds, and the best results for speech reception threshold and speech discriminationscores. The impact of favorable thresholds in Group 3 was better among patients with abaseline average hearing threshold of ＜70 dB. Complete recovery was more likely in Group 3than in the other groups, based on the odds ratios. Conclusion Administration of dexamethasone-based systemic steroid combined with IT steroidinjection and a relatively long hospitalization period produced the most favorable result.
Abstract
Background and Objectives The optimal dose or type of systemic steroid for treating idiopathicsudden sensorineural hearing loss (ISSNHL) is unclear. Herein, we compare the efficacyof three steroid treatment protocols. Subjects and Method We reviewed the medical records of 140 adult ISSNHL patients froma tertiary medical center. The patients were divided into three groups based on their treatmentregimen: Group 1 received intravenous 10 mg/day dexamethasone combined with intratympanic(IT) steroid injection, followed by prednisolone for 5 days after discharge; Group 2 received 10mg/day dexamethasone for 5 days, followed by 5 mg/day for 5 days over a 10-day hospitalizationperiod; and Group 3 received 10 mg/day dexamethasone combined with IT steroid injectionduring a 5-day hospital stay, followed by 5 mg/day dexamethasone for 5 days after discharge. The hearing thresholds were measured using an automatic audiometer at 0.5, 1, 2, 3, 4, and 8kHz. Hearing recovery on Day 90 was categorized according to Siegel’s criteria. Results Univariate and multivariate analyses showed that patients in Group 3 had the lowesthearing thresholds, and the best results for speech reception threshold and speech discriminationscores. The impact of favorable thresholds in Group 3 was better among patients with abaseline average hearing threshold of ＜70 dB. Complete recovery was more likely in Group 3than in the other groups, based on the odds ratios. Conclusion Administration of dexamethasone-based systemic steroid combined with IT steroidinjection and a relatively long hospitalization period produced the most favorable result.
참고문헌 (20)
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