Dextran Therapy in Sudden Deafness: A Quasi Study

Abstract

Objective: To evaluate the treatment outcome of low-molecular-weight dextran in the management of idiopathic sudden sensorineural hearing loss (ISSHL), we conducted this quasi-experimental study to investigate whether subjects receiving additional dextran therapy demonstrated better hearing outcomes than patients receiving corticosteroid alone. Method: Clinical records of 169 patients of ISSHL were reviewed from 2002 to 2010. Gathered information included age, gender, pretreatment hearing, delay of treatment, presence of vertigo and DM. Treatment methods include 1) oral prednisolone (1 mg/kg/d for 7 days) and 2) oral prednisolone plus dextran infusion (500 mL, twice daily). Results: Initial analysis revealed that patients who received dextran therapy tended to have more severe hearing loss and shorter delay of treatment than the steroid group ( P < .01). Therefore, we applied propensity score to control for selection bias. Subjects with the same propensity score represented the same chance of receiving specific treatment. As a result, we re-identified 50 pairs of propensity-score-matched subjects (N = 100) with a homogenous distribution of all clinical factors ( P > .05). Average hearing gain in subjects receiving dextran therapy (plus steroid) were 36.9 ± 20.1 dB, which does not differ from 34.7 ± 22.3 dB for subjects receiving steroid only ( P = .60). Conclusion: Matching of propensity score successfully balanced the heterogeneity between the dextran and steroid group. Analytical result demonstrated that the addition of low-molecular-weight dextran to steroid therapy does not increase therapeutic effectiveness in managing ISSHL. Therefore, routine dextran administration in treating ISSHL should be carefully weighed against its potential hazards.