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

Eftekharian, Ali; Amizadeh, Maryam

doi:10.1002/lary.25244

Cited by 25 publications

(35 citation statements)

References 24 publications

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“…In a randomized controlled trial, where the AAO-HNSF definition was used for the recovery definitions, the overall recovery rate was 55%-59% after 14 days of corticosteroid therapy. [4] Our recovery rates were lower than those observed in the above study. However, the mean age of patients in that study was lesser than that in our study group (40-42 years vs 59-61 years).…”

Section: Discussioncontrasting

confidence: 77%

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Pentoxifylline versus Steroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss with Diabetes

2018

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OBJECTIVES:To compare the efficacy of pentoxifylline with that of conventional steroid therapy in diabetic patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and to compare blood sugar levels during hospitalization. MATERIALS and METHODS:Medical charts were retrospectively reviewed for all diabetic patients admitted to one institution for ISSNHL between 2000 and 2015. We analyzed 298 cases; 50 patients received pulse steroid treatment (steroid group) and 248 received intravenous administration of pentoxifylline only (pentoxifylline group). Hearing change was evaluated by comparing the initial hearing tests with follow-up hearing tests for up to 3 months. Blood sugar levels were also compared between the 2 groups. RESULTS:At 3 months post-treatment, the degree of hearing recovery was similar between the 2 groups. The pure-tone average was improved from baseline by 17.9±21.2 dB in the steroid group and 18.9±20.7 dB in the pentoxifylline group (p=0.776); hearing recovery rates were also similar (40% vs 39.1%; p=0.826). During hospitalization, average fasting blood sugar levels were higher (203.9±92.0 vs 174.4±54.8 mg/dL; p=0.033) and acute hyperglycemia was more common (48.0% vs 33.1%; p=0.044) with steroid versus pentoxifylline treatment. CONCLUSION:Hearing recovery rates did not significantly differ between steroid and pentoxifylline treatment in diabetic patients with ISSNHL, but pentoxifylline appeared to be associated with better blood sugar control.

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Section: Discussioncontrasting

confidence: 77%

“…However, although steroids, including intravenous (IV) pulse therapy or oral prednisolone, are commonly prescribed to treat ISSNHL, a recent Cochrane review of the evidence from randomized controlled trials reported that there is no consensus on their effectiveness [4,5] .…”

Section: Introductionmentioning

confidence: 99%

Pentoxifylline versus Steroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss with Diabetes

2018

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“…Glucocorticoids exert a variety of immunosuppressive, anti-inflammatory, and anti-allergic effects on primary and secondary immune cells and tissues. Systemic steroid treatment is one of the few treatment options that has data showing efficacy and is recommended as first-line therapy in SHL according to 2012 guidelines [13, 16]. As a second-line treatment for non-responding patients (salvage therapy), several possibilities have been proposed: hyperbaric oxygen therapy, intratympanic steroid application, antiviral therapies, vasoactive agents, anticoagulants, rheopheresis and other [13].…”

Section: Discussionmentioning

confidence: 99%

Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss

Košťál

Dršata

Bláha

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

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BackroundOnly few therapeutic options exist for patients with refractory sudden idiopathic sensorineural hearing loss (SISHL). Little is known about the efficacy of second-line therapies. Rheopheresis seems to be an effective therapeutic possibility.MethodsBetween 2012 and 2015, 106 patients with SISHL were enrolled in the study, of whom 52 were refractory to initial treatment. As salvage therapy, these patients were offered either 3 sessions of rheopheresis (33 pts) or intratympanic steroid treatment through MicroWick application (19 pts). Pure tone audiometry was performed at diagnosis, at the 1st month and the 1st year during the follow-up.ResultsPatients in the rheopheretic arm had higher hearing loss than in the MicroWick arm (81% vs. 52%, p = 0.04). In spite of this, there was a significant improvement for patients in the rheopheretic arm (27% of hearing loss reduction, p < 0.001) after the 1st month and this remained unchanged during the 1st year, while no improvement was seen in the MicroWick arm (0% of hearing loss reduction, p = 0.424). We found no predictive factor for steroid-failure in first-line therapy. Older age (p = 0.003), presence of vertigo (p = 0.006) and more profound initial hearing loss (p < 0.001) were identified as negative prognostic markers.ConclusionRheopheresis can be used as a potentially effective and safe salvage therapy for patients with cortico-refractory SISHL.

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“…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 …”

Section: Evidence and Therapeutic Alternativesmentioning

confidence: 99%

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

et al. 2017

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Among various forms of hearing loss, there are acute (within 72 hrs) or subacute (weeks to months) presentations that may be reversible with early pharmacological intervention. The workup of a patient presenting with hypoacusia includes the usual history and physical examination in conjunction with an audiometric assessment in order to categorize the hearing loss as conductive, sensorineural, or mixed. Sudden sensorineural hearing loss and autoimmune inner ear disease are acute and subacute forms of sensorineural hypoacusia most likely to be reversed with prompt pharmacological intervention. Systemic or local corticosteroid therapy has the most evidence of benefit in patients with sudden sensorineural hypoacusia and is the best available first line therapy noted in clinical practice guidelines. Alternative immunosuppressant therapies have not been well studied, and many have serious toxicities that further complicate the benefit-risk assessment. There are no randomized comparisons of corticosteroid dosing regimens that evaluated clinically important outcomes, so expert opinion must serve as the basis for dosing recommendations. Clinicians need to involve patients with hypoacusia in the shared decision-making process, since partial or complete reversal of hearing loss can have substantial quality-of-life implications for affected patients.

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

Abstract: Pulse therapy with methylprednisolone and traditional oral prednisolone therapy resulted in similar hearing improvement.

Cited by 25 publications

References 24 publications

Pentoxifylline versus Steroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss with Diabetes

Pentoxifylline versus Steroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss with Diabetes

Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss

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

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