Effect of high dose intravenous vitamin C on idiopathic sudden sensorineural hearing loss: a prospective single-blind randomized controlled trial

Abstract

The aim of this prospective single-blind randomized controlled study was to evaluate the therapeutic efficacy of high dose intravenous vitamin C (HDVC) added to systemic steroid in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Between August 2010 and August 2011, 72 ISSNHL patients who participated in this study were randomly allocated to two groups: 36 to a control group, members of which were given systemic steroid treatment for 15 days, and 36 to a HDVC group, members of which were given HDVC (200 mg/kg/day) for 10 days in addition to steroid therapy followed by oral vitamin C (2,000 mg) for 30 days after discharge. Finally, we analyzed each group: 35 as a control group and 32 as a HDVC group. Auditory evaluations were performed by pure tone audiometry (PTA) before and ~1 month after treatment using Siegel's criteria. HDVC group showed significantly greater complete and partial recovery improvement (p = 0.035). In addition, the complete recovery rate in the HDVC group was more than twice that of the control group (p = 0.031). In the HDVC group, PTA improved from 67.6 ± 19.8 dB HL before treatment to 37.1 ± 28.8 dB HL at 1 month after treatment, whereas in the control group, PTA improved from 70.3 ± 12.4 to 47.6 ± 25.2 dB HL, which represented a significant intergroup difference (p = 0.030). In conclusion, HDVC may enhance hearing recovery in ISSNHL patients, which suggests that HDVC reduces levels of reactive oxygen metabolites produced by inner ear ischemia or inflammation, and that HDVC could be considered for the treatment of ISSNHL.

Pulse steroid therapy in idiopathic sudden sensorineural hearing loss: A randomized controlled clinical trial

“…The small sample sizes presented in this study limit the certainty of its conclusions. Many studies—or, as Stokroos et al stated—almost every study concerning ISSNHL therapy suffers from this limitation due to the low incidence of the condition, especially when inclusion and exclusion criteria are strictly applied. Multicenteric studies may better overcome this problem.…”

Optimal Dosage of Methylprednisolone for the Treatment of Sudden Hearing Loss in Geriatric Patients: A Propensity Score-Matched Analysis

“…Moreover, it is an expensive and time-consuming treatment method. Other possible options include medications such as antiviral agents [23], vasodilators (such as carbogen, alprostadil, naftidrofuryl, and low-molecular-weight dextran) [24], high-dose vitamins [25], [26], and zinc supplementation [27]. However, the effects of these agents have not been sufficiently studied and there is no evidence to support their use.…”

Evaluation and Treatment of Acute and Subacute Hearing Loss: A Review of Pharmacotherapy

“…In a limited number of published studies, vitamins C and E as well as gingko biloba extract primarily have been investigated as supplemental antioxidant therapy to standard systemic steroid therapy with mixed findings. In one study, vitamin C in combination with steroids was shown to have a greater improvement in PTA and partial and complete recovery compared with the steroid alone group . Similarly, in another study vitamin E in combination with steroids had an overall greater success of treatment compared with systemic steroids alone .…”

“…Full texts of the reports were retrieved for the studies that appeared to fit the eligibility criteria for inclusion in this review. The result of the systematic search and selected studies are included in Table , which lists the interventions (steroid or alternative therapy) and the main outcome measures with interpretation …”