Adverse Effects of Glucocorticoid Therapy for Inner Ear Disorders

Abstract

Background: Because of their anti-inflammatory effects and suppression of the immune system, glucocorticoids have been widely used in otolaryngologic disorders and perioperative conditions. Objective: The objective of the present study was to determine the incidence of adverse effects after the administration of glucocorticosteroids in patients affected by diverse inner ear disorders. Methods: One hundred and sixty-three patients affected by sudden sensorineural hearing loss, 39 with progressive sensorineural hearing loss and 16 with fluctuating sensorineural hearing loss were subjected to glucocorticosteroid therapy with 6-methylprednisolone at a starting dose of 1 mg/kg body weight per day; this therapy was tapered during the next 21–28 days. In 20 patients with profound hearing loss (>70 dB), 3 boluses of prednisolone-21-hydrogen-succinate (500 mg per day) were administered. After receiving the boluses, these patients continued with the oral 6-methylprednisolone scheme. Results: Mild adverse effects were observed in 16 patients (7.01%). Only 2 patients (0.9%) with sudden sensorineural hearing loss showed severe complications: peptic ulcer and avascular necrosis of the femoral heads. Conclusions: The low percentage of severe adverse effects observed in the present study validates the use of corticosteroids for the treatment of inner ear disorders although we should not underestimate these rare complications.

Incidence and US Costs of Corticosteroid-Associated Adverse Events: A Systematic Literature Review

“…A total of 4 studies were excluded from the analysis of AEs because of poor quality. 13,18,26,36 One study was conducted in patients with acute conditions (acute optic neuritis); 26 were conducted in patients with chronic conditions; and 16 were conducted in the general population. Rheumatoid arthritis was the most commonly studied condition (7 publications) followed by acute lymphoblastic leukemia, asthma, SLE, pulmonary diseases, and nonspecified rheumatic disease (2 publications each).…”

Intratympanic Methylprednisolone for Sudden Sensorineural Hearing Loss: Comprehensive Re Examination of the Model

“…The Trans tympanic route has 2 advantages; firstly, it allows a greater concentration of drugs in the perilymph and secondly, it minimizes systemic effects and absorption. Side effects of systemic steroids can greatly compromise a person's quality of life and hinder their capacity to work throughout the treatment period [26].…”

Intratympanic methylprednisolone as first-line therapy in sudden sensorineural hearing loss: preliminary results from a case–control series

“…3 Assessment of the therapeutic efficacy of these treatments has been hampered by lack of understanding of the condition's pathophysiology, and by the high prevalence of spontaneous resolution (up to 65-66 per cent of cases). Such a high systemic steroid concentration carries the risk of unwanted side effects, 8 especially in elderly patients and those with gastric problems, hypertension and diabetes. 7 To be effective the steroids have to reach an adequate perilymphatic concentration that is achieved with very high systemic doses.…”