Short-Term Outcomes of Acute Low-Tone Sensorineural Hearing Loss According to Treatment Modality

Abstract

Background and ObjectivesWe compared improvements in hearing thresholds in acute low-tone sensorineural hearing loss (ALHL) patients after two different treatments: steroid alone and steroid and diuretic combined. We analyzed how the duration between the onset of symptoms and the initiation of treatment affected hearing loss improvement and investigated the relation between presence of vertigo in ALHL patients and ALHL progression to Ménière's disease (MD).Subjects and MethodsWe retrospectively analyzed the medical records of 47 ALHL patients aged 21 to 76 years. Patients received either orally administered steroid alone (n=12) or steroid and diuretic combined (n=35). We compared improvements in the two groups' hearing thresholds at three lower frequencies (125, 250, and 500 Hz) after participants had received one month of each respective treatment.ResultsOur two treatments did not show any statistical difference in hearing loss improvement after one month. Forty percent of ALHL patients with vertigo developed MD, which was a significantly higher rate than the 12.5% of ALHL patients without vertigo who developed MD. The shorter duration between the onset of symptoms and the initiation of treatment significantly increased improvement in the sum of lower frequency hearing threshold after one month.ConclusionsThe current study suggests that steroid and diuretic administered together and steroid alone similarly improve the hearing threshold in ALHL patients after one month. We concluded that patients should initiate ALHL treatment as soon as they experience symptoms. ALHL patients should also be notified of their higher risk of developing MD.

Meta-Analysis Comparing Steroids and Diuretics in the Treatment of Acute Low-Tone Sensorineural Hearing Loss

“…However, as the cochlear hydrops progresses to the vestibular organs, patients with endolymphatic hydrops may experience dizziness, and ALHL progresses to Ménière disease. 4,14,15 Jinkyung et al 14 found that ALHL patients with vertigo had a higher possibility of developing Ménière disease (40%) than those without vertigo (12%). At present, the relationship between ALHL and Ménière disease is not fully understood, and relevant research is still needed in the future.…”

Comparative Analysis of the Combined Therapeutic Effects of Lipoprostaglandin E1 on Sudden Idiopathic Sensorineural Hearing Loss

“…Corticosteroids are the main drugs that are generally used to treat ISSNHL [ 13 14 ]. The action of steroids is uncertain, but they can be beneficial for infectious, inflammatory, and immune-mediated diseases [ 6 ].…”

Penatalaksanaan Acute Low-tone Sensorineural Hearing Loss

“…11 Menurut Chang pemberian kortikosteroid bisa tunggal atau kombinasi dengan. 12 Chang menyimpulkan bahwa pemberian kortikosteroid dapat menjadi pilihan untuk terapi jangka pendek pada pasien ALHL. 12 Menurut Oishi metilprednisolon diberikan dengan dosis 30-60 mg/hari sebagai dosis awal.…”

“…12 Chang menyimpulkan bahwa pemberian kortikosteroid dapat menjadi pilihan untuk terapi jangka pendek pada pasien ALHL. 12 Menurut Oishi metilprednisolon diberikan dengan dosis 30-60 mg/hari sebagai dosis awal. 5 Sedangkan Choi16 memberikan metilprednisolon 40 mg pada hari 1-3, 30 mg pada hari 4-6, 20 mg pada 7-9 dan 10 mg pada hari 10-12.…”

“…Beberapa penelitian sebelumnya juga menyebutkan persentase perbaikan pendengaran meningkat saat pasien mendapatkan terapi inisial 1 minggu setelah onset gejala. 12 Pasien dilakukan audiometri 1 minggu setelah terapi awal dan menunjukkan peningkatan ambang dengar pada frekuensi rendah. Begitu juga dengan audiometri 1 bulan berikutnya.…”