This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (43)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Neurology  • Neuro-otology  • Hearing Loss/ Deafness  • Drug Therapy  • Adverse Effects  • Alert me on articles by topic  Social Bookmarking   What's this?

Does Application of Glucocorticoids Make Sense?

Christoph Alexiou, MD; Wolfgang Arnold, MD; Claudius Fauser, MD; Bruno Schratzenstaller, MD; Bertrand Gloddek, MD; Stefanie Fuhrmann; Kerstin Lamm, MD

Arch Otolaryngol Head Neck Surg. 2001;127:253-258.

Background  Treatment of sudden sensorineural hearing loss (SSNHL) consists of administration of blood flow–promoting drugs with or without the addition of glucocorticoids. General guidelines based on scientific data do not currently exist.

Objective  To investigate the effect of glucocorticoids on the treatment of SSNHL.

Setting  Academic medical center.

Patients and Methods  We retrospectively analyzed the audiograms of 603 patients with SSNHL: 301 patients (cared for between January 1, 1986, and December 31, 1991) received intravenous blood flow–promoting drugs without glucocorticoids and 302 patients (cared for between January 1, 1992, and December 31, 1998) received intravenous blood flow–promoting drugs with glucocorticoids (intravenous ± oral application). The age distribution of patients with SSNHL in lower, middle, and higher frequencies was similar in both groups.

Results  Patients with SSNHL in lower and middle frequencies (250-2000 Hz) who received glucocorticoids (prednisolone-21-hydrogen-succinate) showed significantly better recovery of hearing levels compared with those who did not receive glucocorticoids (P<.05). There was no significant difference at higher frequencies between the 2 groups. Patients with SSNHL throughout all frequencies (pancochlear hearing loss) who received glucocorticoids also had significantly better recovery of hearing levels compared with those who received blood flow–promoting drugs alone (P<.05). Also, patients with elevated blood sedimentation rates had better improvement of their hearing levels after receiving glucocorticoids.

Conclusions  Administration of glucocorticoids should be recommended for treatment of patients with SSNHL. In particular, patients with SSNHL in the lower and middle frequency range and pancochlear hearing loss have significantly better recovery of hearing levels.

From the Department of Otorhinolaryngology–Head and Neck Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Corresponding author and reprints: Christoph Alexiou, MD, Klinikum rechts der Isar, Hals-Nasen-Ohren Klinik und Poliklinik, Ismaningerstr. 22, 81675 München, Germany (e-mail: C.Alexiou{at}lrz.tu-muenchen.de).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Archives of Otolaryngology–Head & Neck Surgery Reader's Choice: Continuing Medical Education
Arch Otolaryngol Head Neck Surg. 2001;127(3):342-343.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Idiopathic Sudden Sensorineural Hearing Loss
Rauch
NEJM 2008;359:833-840.
FULL TEXT  

Glucocorticoid Receptor and Nuclear Factor-{kappa}B Interactions in Restraint Stress-Mediated Protection against Acoustic Trauma
Tahera et al.
Endocrinology 2006;147:4430-4437.
ABSTRACT | FULL TEXT  

Screening and Management of Adult Hearing Loss in Primary Care: Scientific Review
Yueh et al.
JAMA 2003;289:1976-1985.
ABSTRACT | FULL TEXT