Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients

Burschka, Martin A.; Hassan, Hassan Abdel-Hady; Reineke, Thorsten; Bebber, Lara Van; Caird, David; Mösges, Ralph

doi:10.1007/s004050100343

Cited by 53 publications

(30 citation statements)

References 28 publications

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“…Second, the results may have been influenced by cotreatment with ginkgo biloba. Although the current practice guideline recommends not using other drugs such as vasodilators and antioxidants for treatment [Stachler et al, 2012], some studies have reported the benefits of ginkgo biloba for SSNHL in terms of vasomodulation, platelet-activating factor antagonism, antioxidation and antiapoptosis action, and neuroprotection [Burschka et al, 2001;Reisser and Weidauer, 2001]. We prescribed a ginkgo biloba extract to both of our study groups for 2 months, which would not have had differential effects on the results in the 2 groups.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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Objectives: Severe-to-profound sudden sensorineural hearing loss (SSNHL) has a poor prognosis. We aimed to compare the efficacy of simultaneous and sequential oral and intratympanic steroids for this condition. Methods: Fifty patients with severe-to-profound SSNHL (>70 dB HL) were included from 7 centers. The simultaneous group (27 patients) received oral and intratympanic steroid injections for 2 weeks. The sequential group (23 patients) was treated with oral steroids for 2 weeks and intratympanic steroids for the subsequent 2 weeks. Pure-tone averages (PTA) and word discrimination scores (WDS) were compared before treatment and 2 weeks and 1 and 2 months after treatment. Treatment outcomes according to the modified American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria were also analyzed. Results: The improvement in PTA and WDS at the 2-week follow-up was 23 ± 21 dB HL and 20 ± 39% in the simultaneous group and 31 ± 29 dB HL and 37 ± 42% in the sequential group; this was not statistically significant. Complete or partial recovery at the 2-week follow-up was observed in 26% of the simultaneous group and 30% of the sequential group; this was also not significant. The improvement in PTA and WDS at the 2-month follow-up was 40 ± 20 dB HL and 37 ± 35% in the simultaneous group and 41 ± 25 dB HL and 48 ± 41% in the sequential group; this was not statistically significant. Complete or partial recovery at the 2-month follow-up was observed in 33% of the simultaneous group and 35% of the sequential group; this was also not significant. Seven patients in the sequential group did not need intratympanic steroid injections for sufficient improvement after oral steroids alone. Conclusions: Simultaneous oral/intratympanic steroid treatment yielded a recovery similar to that produced by sequential treatment. Because the addition of intratympanic steroids can be decided upon based on the improvement after an oral steroid, the sequential regimen can be recommended to avoid unnecessary intratympanic injections.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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“…Some authors defined the audiologic inclusion criteria in relation to the opposite (unaffected ear). Compared with these studies, our population met these criteria completely (Q15 dB relative to opposite ear in 1 frequency [12]) or to a large extent, i.e., 94% of our patients met the criterion of 20 dB or greater hearing loss compared with the opposite ear in at least 3 frequencies, as defined by Cinamon et al (30). We therefore considered our study population representative of other populations with ISSHL to a large extent.…”

Section: Table 3 Summary Of the Comparison Of Hearing Improvement Usmentioning

confidence: 93%

“…In addition, we extended our analysis by using a frequency combination covering a wide range of the audiogram, as suggested in a large, randomized controlled trial (9PTA) (13). Because ideally, one would like to measure improvement only in those frequencies that have been affected, we also used an approach suggested by Burschka et al (12). The authors quantified hearing improvement only for frequencies that showed a hearing level of at least 15 dB higher than the hearing level of the contralateral ear at the same frequency (5PTA aff Table 1) (12).…”

Section: Statistical Evaluationmentioning

confidence: 99%

“…Because ideally, one would like to measure improvement only in those frequencies that have been affected, we also used an approach suggested by Burschka et al (12). The authors quantified hearing improvement only for frequencies that showed a hearing level of at least 15 dB higher than the hearing level of the contralateral ear at the same frequency (5PTA aff Table 1) (12). In addition, we adopted this method for a wider frequency range (9PTA aff ) in our analysis.…”

Section: Statistical Evaluationmentioning

confidence: 99%

“…For PTA calculation, the sum of the hearing level at the respective frequencies is divided by the number of frequencies contributing. Affected frequencies are those at which the hearing level is at least 15 dB higher than the hearing level in the contralateral (unaffected) ear at the same frequency (12). The sum is hereby divided by the number of affected frequencies within this range.…”

Section: Statistical Evaluationmentioning

confidence: 99%

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Comparison of Pure-Tone Audiometry Analysis in Sudden Hearing Loss Studies

Plontke

Bauer²,

Meisner³

2007

Otology &Amp; Neurotology

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The lack of an acceptable agreement between most measurement methods assessed in this report prevents a meaningful comparison of published clinical studies on ISSHL. For comparison of efficacy between different treatments in ISSHL and for the planning of controlled clinical trials, it is necessary to agree on standardized outcome measures, including the frequencies averaged and the criteria of success.

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Treatment of Sudden Sensorineural Hearing Loss

Conlin

Parnes²

2007

Arch Otolaryngol Head Neck Surg

225

153

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Objective: To identify, evaluate, and review randomized controlled trials (RCTs) on the treatment of sudden sensorineural hearing loss (SSHL). Data Sources: A MEDLINE search and hand search were conducted to identify RCTs published between January 1966 and February 2006 in the English language on the treatment of SSHL. Search terms included hearing loss, sensorineural (MeSH term), sensorineural hearing loss (text words), and sudden deafness (text words). Study Selection: Prospective RCTs on the treatment of patients diagnosed as having SSHL. Data Extraction: One independent observer extracted study data. Validity was evaluated using standard criteria. Characteristics and results were reviewed systematically. Data Synthesis: A total of 21 RCTs were identified regarding various treatments, including systemic and intra-tympanic steroids; antiviral and hemodilution agents; mineral, vitamin, and herbal preparations; batroxobin; carbogen; and hyperbaric oxygen. All studies used audiometric outcome measures. Only 2 studies used identical criteria to define SSHL. The method of randomization was described in 2 studies. Validity scores ranged from 2 to 8 (of 9). Positive results were reported favoring systemic steroids, intratympanic steroids, batroxobin, magnesium, vitamin E, and hyperbaric oxygen, although there were serious limitations in each study with a positive finding. There was no difference in audiometric outcomes reported across all studies of antiviral and hemodilution agents and no difference in one study of systemic steroids vs placebo. Conclusions: To our knowledge, no valid RCT exists to determine effective treatment of SSHL. Systemic steroids cannot be considered the gold standard of treatment of SSHL, given the severe limitations of the landmark study supporting their use.

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Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients

Cited by 53 publications

References 28 publications

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

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

Comparison of Pure-Tone Audiometry Analysis in Sudden Hearing Loss Studies

Treatment of Sudden Sensorineural Hearing Loss

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