A comparison of single-dose and multiple divided daily-dose oral steroids for sudden sensorineural hearing loss

Gun Hee Yu,Yong-Jun Choi,Hahn Jin Jung,Yun-Sung Lim,Seok-Won Park,Chang Gun Cho,Joo Hyun Park

doi:10.1016/j.bjorl.2018.06.001

Abstract

IntroductionGlucocorticoids are considered the first-line therapy for sudden sensorineural hearing loss. But there is currently no consensus on administering them as a single dose versus multiple divided daily doses. ObjectiveWe aim to evaluate the treatment outcome of sudden sensorineural hearing loss between a single-dose and multiple divided daily doses of steroid treatment. MethodsA total of 94 patients who were diagnosed and treated for sudden sensorineural hearing loss and followed up for more than three months were reviewed retrospectively. Patients were divided into single-dose and multiple divided-dose groups, based on their medication regimens. Hearing thresholds were repeatedly measured: on the initial visit and 1 week, 1 month, and 3 months after the initial treatment. Treatment outcomes were analyzed by comparing hearing recovery rates and post-treatment audiometric changes. ResultsThe hearing threshold was significantly reduced at three months post-treatment in both groups. The hearing recovery rate of the single-dose group was significantly higher than that of the multiple divided-dose groups. Audiometric changes showed no statistical difference either in pure tone threshold or speech discrimination. ConclusionWhen oral steroids are indicated for sudden sensorineural hearing loss, both a single dose and multiple divided doses can be effective for treatment and have comparable results. However, the single-dose regimen seems to be more efficacious than the divided-dose regimen.

Highlights

Glucocorticoids are considered the first-line therapy for sudden sensorineural hearing loss
The single-dose group included 34 patients, and 95 patients were assigned to the divided-dose group, according to their steroid regimen
There were no significant differences in age, sex, incidences of associated vertigo, hypertension and diabetes mellitus, and interval of onset of hearing loss and steroid treatment between the two groups (Table 2)

Summary

Introduction

Glucocorticoids are considered the first-line therapy for sudden sensorineural hearing loss. There is currently no consensus on administering them as a single dose versus multiple divided daily doses. Objective: We aim to evaluate the treatment outcome of sudden sensorineural hearing loss between a single-dose and multiple divided daily doses of steroid treatment. Glucocorticoids are considered a first-line therapy for sudden sensorineural hearing loss (SSNHL) and may be administered systemically (generally orally). The mechanism of the steroid action in the inner ear remains unclear, high concentrations of steroids in the inner ear via high doses of oral steroids have shown an adequate therapeutic effect.[1] there is currently no consensus whether giving a single dose versus multiple divided daily doses of glucocorticoids is preferable.

Objectives

Methods

Results

Conclusion