A Prospective, Multi-Centered Study of the Treatment of Idiopathic Sudden Sensorineural Hearing Loss With Combination Therapy Versus High-Dose Prednisone Alone

Abstract

Combination therapy offers ISSNHL patients the highest likelihood of achieving class A and B hearing. Differential results with combination therapy and HDPT compared with previous studies suggest time- and dose-dependent responses to the treatment of ISSNHL.

Simultaneous versus Sequential Intratympanic Steroid Treatment for Severe-to-Profound Sudden Sensorineural Hearing Loss

“…In a study by Wen et al [2014] regarding profound SSNHL, the overall recovery rate was 8.6% in the sequential group and 4.7% in the oral steroid only group. In the subgroup of profound SSNHL in the study of Battaglia et al [2014], simultaneous treatment resulted in a rate of 40% overall recovery, compared with 16.7% of the oral steroid treatment alone [Battaglia et al, 2014]. In the present study, 90% of the patients showed more than slight improvement and 33-35% recovered to serviceable hearing (CR or PR).…”

“…Although this concentration is lower than those used in prior publications (i.e., 12-62.5 mg/mL dexamethasone or 40 mg/mL methylprednisolone) for IT [Battaglia et al, 2014;Filipo et al, 2013;Seggas et al, 2011], there is still no consensus about the appropriate concentration or injection schedule for IT in SSNHL [Stachler et al, 2012]. Because the only commercially available concentration of dexamethasone in Korea is 5 mg/mL, several previous studies conducted in Korea have used the same dexamethasone concentration [Ahn et al, 2008;Kim et al, 2012;Lee et al, 2010;.…”

“…It has been reported that the likelihood of hearing recovery after simultaneous therapy is higher than that of either therapy alone [Arslan et al, 2011;Battaglia et al, 2008Battaglia et al, , 2014. However, other reports show no superiority of simultaneous therapy over systemic therapy alone or IT steroid alone [Ahn et al, 2008;Lim et al, 2013].…”

Therapeutic efficacy of salvage hyperbaric oxygen therapy in sudden sensorineural hearing loss after failure of steroids

“…Although the efficacy of steroids in ISSNHL is still conflicting irrespective of the delivery method, recent previous studies found that combined steroid treatment (systemic steroid+ITS) provides better hearing recovery than systemic steroid alone. [6,7] Suzuki et al reported that systemic plus intratympanic steroid administration is more effective than systemic steroid plus HBO therapy. [19] It is believed that the diffusion of higher steroid concentration into cochlear fluids reduces inflammation in the inner ear.…”

“…Recently, data from three randomized controlled studies showed the benefit of combination therapy, especially in patients with mild-to-severe hearing loss. [6][7][8] In our institution, we have been preferring combination therapy as the initial management for ISSNHL and HBO therapy as salvage or adjuvant therapy after failure of combination therapy since 2013.…”