There is no consensus regarding treatment modalities for idiopathic sudden sensorineural hearing loss (SNHL). In order to evaluate the effectiveness of steroid or carbogen inhalation therapies, a prospective double-blind placebo controlled study was designed. All 41 patients enrolled in the study had unilateral SNHL with no prior history of SNHL, otological pathological history or otoscopic findings. Patients were assigned to four treatment groups: prednisone tablets, placebo tablets, carbogen inhalation or room air inhalation. All were treated for 5 days. The audiometric data at admission was compared to that at day 6 and to data collected at follow-up (average 33 days). Results revealed no significant difference between the groups for early or late audiometric outcome. Age, time from onset of symptoms to initiation of treatment, tinnitus, audiogram configuration, and the presence of vertigo at onset did not significantly affect the outcome. The discrimination scores that were poor in all patient groups on admission improved within days in all groups. These findings suggest that steroids or carbogen inhalation have no therapeutic advantage over placebo. Also, regardless of treatment modality, hearing continued to improve for at least a month after treatment was stopped.

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This review suggests a reference to the postnatal growth of mastoid air cells and bone. Information was retrieved from studies having large consecutive age groups, in order to reveal a development pattern. Data regarding origin, gender, and antibiotic treatment was investigated as well. Most measurements were obtained by planimetry. Assessment of the various data sources suggested the antrum to be well developed at birth (1-1.5 cm2), the mastoid cells to be about 3.5-4 cm2 at 1 year, followed by a linear growth till the age of 6 (1-1.2 cm2/year), having a slower increment up to adult size at puberty (approximately 12 cm2). The mastoid bone expansion is about 0.6-0.9 cm/year in length and width and 0.4 cm/year in depth in the first year, followed by half that rate until the age of 6-7. At puberty there was a slower sprout reaching adult size. Different ethnic groups share similar mastoid aeration and bone growth patterns. There were no differences between mastoid aeration measured at the pre-antibiotic era and after its widespread use. In conclusion, there are three distinguishable phases of mastoid pneumatization from birth till reaching final size. Bone and air cell compartments share a similar growth pattern; bone expansion lags behind aeration. Antibiotic treatment for otitis may have no impact upon mastoid aeration.