Abstract
A hurdle in the evaluation of any therapy of ISHL has previously been proposed-a spontaneous recovery of satisfactory hearing of 63% of patients. The hurdle has yet to be convincingly passed by any drug therapy. The intent here is not to denigrate the use of drugs in this syndrome; on the contrary, it remains likely that some subgroups of ISHL would benefit from specific medical management. For instance, a systemic viremia would be most logically treated with anti-inflammatory agents and a thrombotic event with anticoagulants. However, prospective studies in which patients are divided into prognostic categories before treatment with adequate control groups must be performed.
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