Treatments for Idiopathic Sudden Hearing Loss: Literature Review

Abstract

Idiopathic sudden hearing loss is characterized by an acute onset of hypoacusis, usually unilateral, occurring in less than 72 hours and with a loss equal to or greater than 30 decibels (dB) in at least three consecutive audiometric frequencies. In 71% of cases, the etiology is idiopathic. The symptoms are unpleasant and limiting, so a proper therapeutic plan is needed to minimize the impact on patients' lives. The purpose of this study is to describe treatment modalities, characterize the action mechanism, describe the efficacy and identify the risks of the therapeutic modalities. This is a study of narrative literature review; the articles were taken from Pubmed, Scielo, National Library of Medicine and Google Scholar databases. 35 articles from 1995 to 2023 were analyzed. In the studies, it was reported that treatment of idiopathic sudden hearing loss is controversial due to the different etiological and pathophysiological theories, being based on: systemic corticosteroid therapy, intratympanic corticosteroid therapy, hyperbaric oxygen therapy, antivirals and vasoactive or vasodilating substances. It is concluded that, although there is little high-quality evidence to prove the superiority of any treatment, those with the best risk-benefit ratio should be used. Systemic corticosteroid therapy may be used, associated or not with intratympanic corticosteroid therapy and hyperbaric oxygen therapy according to availability. Antivirals and vasodilators may be disregarded.