Defibrinogenation Therapy for Idiopathic Sudden Sensorineural Hearing Loss in Comparison with High-dose Steroid Therapy

Abstract

These results indicate that high-dose steroid therapy should be employed in preference to defibrinogenation therapy for patients with moderate hearing loss, whereas defibrinogenation therapy has an advantage for those with severe hearing loss, in view of its lower frequency of side-effects.

Clinical Practice Guideline

“…Multiple poorly controlled studies have failed to show clinical improvement of this form of therapy. 190 Finally, diatrizoate meglumine (Hypaque) is an intravenous contrast agent that has been postulated to improve hearing in patients with SSHNL. An analysis of Hypaque vs steroids vs vasodilator showed no better results with any of those treatments than the published spontaneous recovery rate of 65%.…”

Comparação entre critérios de recuperação auditiva na perda neurossensorial súbita

“…Wilson et al 4 reported a recovery rate of 61% in patients taking steroids, while in our sample significant recovery was found in only 34.6% of these patients. Suzuki et al 8 reported a significant recovery average of 52.2% including patients on steroids or batroxobin, while our significant recovery rate remained at 38.6%. One of the possible reasons that may have contributed to this discrepancy is the fact that our study used pure--tone averages covering all affected frequencies and all higher frequencies, while the original studies used only the 0.5, 1 and 2 kHz bands and the 0.25, 0.5, 1, 2, and 4 kHz bands respectively.…”

“…Criterion B used by Suzuki et al 8 , when assessing absolute hearing recovery in decibels, fails to consider the initial degree of established hearing loss.…”

“…• Criterion A: significant recovery -improvement of at least 10 dB between the initial and final PTA as described by Stokroos et al 7 ; • Criterion B: significant improvement -improvement of at least 30 dB between the initial and final PTA or when final hearing thresholds are under 20 dB or the thresholds of the healthy ear have been reached; and full recovery -final hearing thresholds are under 20 dB or the thresholds of the healthy ear have been reached as described by Suzuki et al 8 ;…”

“…However, the Ministry of Health, Labor and Welfare of Japan Study Group for Sudden Deafness recommends the use of the average at 0.25, 0.5, 1, 2, and 4 kHz and considers full recovery when the PTA or the thresholds of the healthy ear has reached thresholds under 20 dB; important recovery occurs when improvements are of at least 30 dB; minor recovery when it ranges between 29 and 10 dB; and no recovery when the improvement remains under 10dB. This set of criteria was also used by Suzuki et al 8 . Other authors have adopted stricter hearing recovery criteria, as is the case of Penido et al 9 , for whom full recovery occurs when the PTA at 0.5, 1, 2, and 4 kHz has improved by over 90% based on a normal audiometric level of up to 25 dB; partial recovery was set between 21% and 90%; and no recovery when improvements were under 20%.…”