Steroids for idiopathic sudden sensorineural hearing loss

Wei, Benjamin; Stathopoulos, Dimitra; O’Leary, Stephen

doi:10.1002/14651858.cd003998.pub3

Cited by 184 publications

(128 citation statements)

References 90 publications

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“…The anti-inflammatory effects of steroids have been proposed to be beneficial in patients with virus induced sudden hearing loss [6]. On the other hand, it has also been reported that steroid has no significant benefit in ISSNHL [7]. Antiviral agents [8], vasodilators, and fibrinogen apheresis have been applied in ISSNHL [9], but their efficacies have not been established.…”

Section: Discussionmentioning

confidence: 99%

Effect of high dose intravenous vitamin C on idiopathic sudden sensorineural hearing loss: a prospective single-blind randomized controlled trial

Kang¹,

Park

Ahn

et al. 2012

Eur Arch Otorhinolaryngol

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The aim of this prospective single-blind randomized controlled study was to evaluate the therapeutic efficacy of high dose intravenous vitamin C (HDVC) added to systemic steroid in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Between August 2010 and August 2011, 72 ISSNHL patients who participated in this study were randomly allocated to two groups: 36 to a control group, members of which were given systemic steroid treatment for 15 days, and 36 to a HDVC group, members of which were given HDVC (200 mg/kg/day) for 10 days in addition to steroid therapy followed by oral vitamin C (2,000 mg) for 30 days after discharge. Finally, we analyzed each group: 35 as a control group and 32 as a HDVC group. Auditory evaluations were performed by pure tone audiometry (PTA) before and ~1 month after treatment using Siegel's criteria. HDVC group showed significantly greater complete and partial recovery improvement (p = 0.035). In addition, the complete recovery rate in the HDVC group was more than twice that of the control group (p = 0.031). In the HDVC group, PTA improved from 67.6 ± 19.8 dB HL before treatment to 37.1 ± 28.8 dB HL at 1 month after treatment, whereas in the control group, PTA improved from 70.3 ± 12.4 to 47.6 ± 25.2 dB HL, which represented a significant intergroup difference (p = 0.030). In conclusion, HDVC may enhance hearing recovery in ISSNHL patients, which suggests that HDVC reduces levels of reactive oxygen metabolites produced by inner ear ischemia or inflammation, and that HDVC could be considered for the treatment of ISSNHL.

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Section: Discussionmentioning

confidence: 99%

Effect of high dose intravenous vitamin C on idiopathic sudden sensorineural hearing loss: a prospective single-blind randomized controlled trial

Kang¹,

Park

Ahn

et al. 2012

Eur Arch Otorhinolaryngol

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“…In addition, recent systematic reviews have failed to identify the exact merit of systemic steroids in the treatment of SSNHL [60], and provided no evidence of superior outcomes over placebo [61], thus questioning their value as a gold standard [62]. The high rate of spontaneous recovery in patients with SSNHL (30-65%) [5], however, may be at least partially responsible for the controversy in the aforementioned clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Are intra-tympanically administered steroids effective in patients with sudden deafness? Implications for current clinical practice

Vlastarakos

Papacharalampous

Maragoudakis³

et al. 2011

Eur Arch Otorhinolaryngol

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Over 60 years since its first report, sudden sensorineural hearing loss (SSNHL) still represents an ill-explained condition, with potentially devastating effects for the quality of life of previously well patients. The present study critically reviewed the available evidence regarding the efficacy of intra-tympanic steroid administration in the treatment of SSNHL. Factors affecting that efficacy were also explored. The literature was systematically reviewed in Medline and other database sources until July 2011, and analyzed through critical analysis of pooled data. The study selection included multi-center prospective randomized control trials, prospective randomized comparative, prospective comparative and prospective studies, retrospective comparative and retrospective studies. The total number of analyzed studies was 43. Intra-tympanic steroids appear to be effective as primary (strength of recommendation A), or salvage treatment (strength of recommendation B) in SSNHL. It is difficult to draw definite conclusions regarding the efficacy of combination therapy. The identification of a time window for effective treatment in the former two approaches yields a grade C strength of recommendation. Primary intra-tympanic treatment is the most effective modality in terms of complete hearing recovery (34.4% cure rate). There is not enough evidence to attribute treatment failures to impaired permeability of the round window membrane. Most complications of intra-tympanic treatment are minor, temporary, and conservatively managed. Intra-tympanic steroids can theoretically provide a more organ-specific treatment in patients with SSNHL. The observation that they seem effective both as primary and salvage treatment modalities with a very low complication rate may have serious implications for current clinical practice.

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“…Nach der aktuellen Fassung der Leitlinie der Arbeitsgemeinschaft der wissenschaftlichen medizinischen Fachgesellschaften (AWMF) "Hörsturz (akuter idiopathischer sensorineuraler Hörver-lust)" [3] wird die hoch dosierte Gabe von Steroiden befürwortet, auch wenn der Nutzen des Einsatzes von Steroiden in der Cochrane-Analyse als unklar eingestuft wird [47].…”

Section: Intratympanale Injektionstherapie Bei Therapierefraktärem Höunclassified

Intratympanale Injektionstherapie bei therapierefraktärem Hörsturz

Mühlmeier

Maier

et al. 2015

HNO

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Steroids for idiopathic sudden sensorineural hearing loss

Abstract: The value of steroids in the treatment of idiopathic sudden sensorineural hearing loss remains unclear since the evidence obtained from randomised controlled trials is contradictory in outcome, in part because the studies are based upon too small a number of patients.

Cited by 184 publications

References 90 publications

Effect of high dose intravenous vitamin C on idiopathic sudden sensorineural hearing loss: a prospective single-blind randomized controlled trial

Effect of high dose intravenous vitamin C on idiopathic sudden sensorineural hearing loss: a prospective single-blind randomized controlled trial

Are intra-tympanically administered steroids effective in patients with sudden deafness? Implications for current clinical practice

Intratympanale Injektionstherapie bei therapierefraktärem Hörsturz

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