To the Editor: We read with interest the article of Tabuchi et al. (1). We would like to present our experience in this matter. As described in the literature, there have been many animal experiments conducted confirming protective affection of glucocorticoids against acoustic injury-they are methodologically different (different animals, protocols of inducing injury, and assessment of damage). This makes comparison of results and conclusions very difficult. Authors examined only one protocol for inducing acoustic injury (4-kHz pure tone at a 128-dB sound pressure level for 4 h), observed auditory brainstem response (before, immediately after, and 2 weeks after acoustic overexposure), and percentage of missing mice hair cells at the cochlear region 3.33 mm from the apex (2 wk after acoustic exposure). We examined the protocol with wideband noise at sound pressure level of 120 dB for 48 hours and observed the extensiveness and the decrease in the dynamics of chicken's hair cell injury (immediately, 3, 7, and 14 d after exposure). In the literature, we found only one study on the effect of steroids on inner ear damages induced by wideband noise. Wideband noise causes injuries on the bigger area of the hearing organ compared with pure tone. In chickens, wideband noise produced stripelike lesions of the tall hair cells along the superior edge, mainly in the middle and proximal parts of the basilar papilla. Pure-tone noise produced only patchlike damage to the region of the short hair cells. Henry (3) gave high doses of methylprednisolone to mice (40 mg/kg i.m.) before, during, and after exposure to wideband noise and proved, using auditory brainstem response, its protective effect on the hearing organ. Our study was conducted on 40 White Leghorn chickens (80 ears) according to the method given by Sliwinska-Kowalska et al. (4). Quantitative analysis showed lesser injuries when high doses of methylprednisolone (30 mg/kg i.m.) were provided during 48-hour exposure to noise, compared with the group which did not receive steroids (15-30% and 45-55%, respectively, of damaged cells at the test immediately after exposure) (Fig. 1).FIG. 1: Percentage of damaged hair cells immediately after 48-hour acoustic exposure.When methylprednisolone was provided only after exposure to noise, it improved dynamics of some repairing processes of hair cells, compared with the group, which did not receive steroids. Qualitative analysis of chickens that received methylprednisolone during exposure to noise showed low percentage of damaged cells, but the remaining cells featured excessive cytomorphological changes that may be protective for these cells. The following changes were found: protuberance of cuticular plates, strongly narrowed cell bodies, and wider intercellular spaces with penetrating supportive cells. This can also be considered as an additional protective mechanism for hair cells, similar to "water pillow" effect, eliminating the damaging results of acoustic vibrations. Our results suggest that methylprednisolone, provided during acoustic overexposure to wideband noise, reduced injuries of chicken's inner ear; provided after exposure, it might promote recovery of reversible damages of hearing cells. This study made us change our treatment protocol for patients with sudden sensorineural hearing loss (5). Waldemar Narozny, M.D., Ph.D. Jerzy Kuczkowski, M.D., Ph.D. Boguslaw Mikaszewski, M.D., Ph.D. Department of Otolaryngology Medical University of Gdańsk Gdańsk, Poland