Prostaglandin E1 in combination with hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss

CONCLUSIONS: Prostaglandin E1 (PGE1) is less effective than stellate ganglion block (SGB) in the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) patients with severe hearing losses when used together with hyperbaric oxygen (HBO) therapy. In contrast with the systemic action of intravenous PGE1, SGB's localized vasodilating action may explain its advantage over intravenous PGE1. OBJECTIVES: To investigate the effect of PGE1 plus HBO therapy on ISSNHL in comparison with that of SGB plus HBO therapy. PATIENTS AND METHODS: We retrospectively analyzed 205 consecutive patients with ISSNHL (hearing levels > or = 40 dB; time from the onset of hearing loss to the start of treatment < or = 30 days). Ninety-five patients underwent intravenous PGE1 plus HBO therapy (PG group) and 110 underwent SGB plus HBO therapy (SGB group). Hearing recovery was evaluated by grade assessment and by hearing improvement compared to that in the unaffected contralateral ear. RESULTS: The overall hearing outcome was not statistically different between the two groups. For patients with initial hearing levels <80 dB, the groups had roughly equivalent hearing outcomes, whereas in patients with initial hearing levels > or = 80 dB, the hearing improvement rate was significantly higher in the SGB group than in the PG group (53.0 +/- 5.0% vs 35.3 +/- 6.8%; p <0.05).     

Intratympanic corticosteroids for sudden idiopathic sensorineural hearing loss.

OBJECTIVE: To determine whether instillation of intratympanic steroids is effective in the treatment of sudden idiopathic sensorineural hearing loss. METHODS: A retrospective chart review of all patients who underwent intratympanic steroid treatment (methylprednisolone and/or dexamethasone) between 1996 and 2002 at a tertiary care university otology clinic. Thirty-three patients were identified, of which 26 met inclusion criteria for having an idiopathic hearing loss. Pretreatment and posttreatment pure-tone audiograms and speech discrimination scores were compared. RESULTS: Overall, there was a 27.2 +/- 5.7 dB improvement in the pure-tone thresholds and a 25.4 +/- 6.2% improvement in speech discrimination scores. Those treated within 10 days of onset had a statistically significant better outcome than those treated after 10 days. No adverse reactions or complications were reported. CONCLUSION: Instillation of intratympanic steroids represents a safe and potentially effective treatment of sudden idiopathic sensorineural hearing loss.     

Hyperbaric oxygenation therapy in idiopathic sudden sensory neural hearing loss

We analyzed statistically the prognosis of hearing impairment in patients with idiopathic sudden sensory neural hearing loss. 119 patients (HBO group) were treated with a combination of hyperbaric oxygenation (HBO) and stellate ganglion block (SGB), as well as oral administration of vasodilator and vitamins. Another 107 patients (control group) were treated with various other therapies. Collectively, the therapeutic outcome in the HBO group was better than in the control group. In addition, the recovery rate of hearing in the HBO group was superior to that in the control group for those cases which had severe hearing loss at the first medical examination, had been seen more than two weeks after onset, and had resisted other treatments. As a result of this study, we conclude that HBO is an effective therapeutic tool.     

Vitamin E and vitamin C in the treatment of idiopathic sudden sensorineural hearing loss

CONCLUSION: The results of this study suggest that the administration of vitamin E and vitamin C to patients with idiopathic sudden sensorineural hearing loss (ISSHL) has beneficial effects by reducing the level of reactive oxygen metabolites produced by inner ear ischaemia and reperfusion injury after treatment. OBJECTIVES: The purpose of this study was to investigate the efficacy of antioxidant vitamin E and vitamin C in the treatment of ISSHL. PATIENTS AND METHODS: In a retrospective chart review, a total of 87 patients were enrolled who fulfilled the following inclusion criteria: 1) sudden onset of sensorineural hearing loss, 2) cause of hearing loss unknown, 3) hearing loss did not fluctuate, 4) arithmetic mean of hearing levels at 250, 500, 1000, 2000 and 4000 Hz exceeded 40 dB and 5) treatment was started within 14 days from the onset of hearing loss. All the patients were treated with steroids and/or alprostadil. In the study group, patients additionally received vitamin E (tocopherol nicotinate, 600 mg/day) and vitamin C (1200 mg/day) orally. RESULTS: The hearing gain after therapy was 29.4 dB and the improvement rate was 63.3% in the study group, compared with 18.5 dB and 44.0% in the control group. Significant improvement was seen in the hearing gain and recovery rate in the study group.     

Treatment of 522 patients with sudden deafness performed oxygenation at high pressure

INTRODUCTION: Oxygenation at high pressure (OHP) is thought to be useful, even though regional blood flow is decreased, because increasing dissolved oxygen prevents the death of nerve tissue. In this report, we retrospectively investigated the effect of OHP on sudden deafness. OBJECT AND METHOD: We reviewed 522 patients treated with OHP at Kagawa Rosai Hospital over a ten-year period (January 1989 to December 1998). We discussed some prognostic factors: comparison between cases which had been treated with OHP previously and those which had not, number of days between onset and beginning of the treatment which included OHP, age, initial averaged five-frequency hearing level, vertigo, tinnitus, complications of OHP, cases of relapse and the time of the onset, which is about season, month and week. OHP was administered at a pressure of 2.5 atmospheres for 80 minutes a day from 10 to 15 times. All patients also received a course of intravenous administration of steroid, vitamin B12, Prostaglandin E1, ATP, and low-molecular dextran. RESULTS: Overall, complete recovery occurred in 19.7% of the patients, definite improvement in 34.9% (complete recovery included), and slight improvement in 58.1% (definite improvement included). Most of the patients (78.0%) were referred by other hospitals, because our hospital was the only one in the Sikoku area which had a big equipment of OHP. All 161 patients had already been treated in other hospitals over 8 days, but they had shown little improvement after the initial therapy. Of this group, complete recovery after the second course of treatment occurred in 13.0% of the patients, definite improvement in 19.3%, and slight improvement in 39.1%. OHP was thus effective for about 40% of patients who had been unresponsive to the initial therapy. Delay in treatment usually produces poor hearing recovery. There was a significant difference between those patients treated within 14 days and those treated 15 days or more after onset. The improvement rate also decreased with age. The prognosis of patients with vertigo was worse than those without vertigo. Tinnitus had no influence on the prognosis. There were no severe complications during the course of OHP, but otitis media with effusion occurred in 90 patients, and paracentesis was performed for 53 patients. CONCLUSION: The treatment of sudden deafness with OHP has been discussed in this report. Important prognostic factors were time between onset and beginning of the treatment which included OHP, age, vertigo, and the initial averaged five-frequency hearing level. We conclude that OHP should be performed within 14 days from onset, and that OHP was able to achieve hearing improvement in many cases unresponsive to the initial therapy if it was performed very early.     

鼓室内注射地塞米松治疗极重度以上突发性聋的临床研究

目的 评估鼓室内注射地塞米松在极重度以上突发性聋仞始治疗中的作用.方法 以发病2周内,未接受任何治疗,初始听力损失(250～4000 Hz均值)>90 dB的突发性聋患者78例作为研究对象,根据患者意愿分为全身激素+局部激素组(22例)、全身激素组(44例)和局部激素组(12例),各组均同时给予扩血管、营养神经的药物治疗和高压氧治疗.全身激素治疗采用地塞米松15 mg/d连用3 d,随后10 mg/d用3 d,最后5 mg/d用3 d.局部激素治疗采用鼓窜内注射5 mg/ml地塞米松0.8 ml,隔日1次,共5次.获取治疗后第10、20、30天的纯音测听结果并进行疗效评估.结果 治疗前影响预后的因素三组间基本匹配.治疗后纯音听阈均值(pure tone average,PTA)改善≥30 dB者所占比例,全身+局部激素组81.82%、局部激素组83.33%、全身激素组88.64%,三组间差异无统计学意义(P=0.726);治疗30 d后PTA改善值分别为:全身+局部激素组41.36 dB、局部激素组43.08 dB、全身激素组51.70 dB,三组间差异无统计学意义(F=1.58,P=0.2133).各组患者治疗后10 d听力改善最为显著,20 d听力基本稳定.纯音测听各频率听阈的改善程度由低频向高频逐渐递减.结论 局部激素治疗作为极重度以上突发性聋的初始治疗与全身激素治疗相比并无优越性.     

Recovery of hearing: results of delayed medical treatment in patients with idiopathic sudden hearing loss

For the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL), a variety of studies about intravenous drug administration with the beginning of treatment in the early period of less then one week after the onset of hearing loss have been performed. In contrast, very little information is available about the efficacy of intravenous drug therapy for ISSNHL with the beginning of treatment later than four weeks after the onset of hearing loss. In a retrospective chart review we studied the treatment results of 57 patients with ISSNHL with beginning of treatment later than four weeks after the onset of hearing loss with no spontaneous recovery of hearing.Patients received a treatment with intravenous administration of Dextran (concentration 40 g/l with NaCl 0.9%) and Procain-HCl (a derivative of the local anaesthetic lidocaine,400-800 mg in a 500 ml rheologic infusion of Dextran 40). 25% of the patients showed a significant improvement of 10 dB or more in hearing threshold at 1000 Hz measured in bone-conducted pure tone audiometry. In a subjective evaluation 53% of the patients noticed a subjective improvement of their individual hearing thresholds.     

Prostaglandin E1 versus steroid in combination with hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss

OBJECTIVE: We conducted a controlled retrospective analysis of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) in order to investigate the effect of prostaglandin E1 (PGE1) plus hyperbaric oxygen (HBO) therapy in comparison with that of steroid plus HBO therapy. METHODS: One hundred and ninety-six consecutive patients with ISSNHL (hearing levels > or ==40dB; time from the onset of hearing loss to the start of treatment < or ==30 days) were enrolled. Ninety-five patients underwent PGE1 plus HBO therapy (PG group) and 101 underwent steroid administration plus HBO therapy (steroid group). Hearing recovery was evaluated by grade assessment and by the improvement in hearing compared to the unaffected contralateral ear. RESULTS: The hearing levels after treatment were 52.2+/-3.0 and 47.5+/-2.8dB, the hearing gains were 31.3+/-2.2 and 27.2+/-2.3dB, the cure rates were 28.4% and 28.7%, the recovery rates were 54.7% and 53.5%, and the hearing improvement rates were 48.4+/-5.1% and 53.9+/-4.2% in the PG and steroid groups, respectively. There were no significant differences between the two groups. CONCLUSION: We concluded that PGE1 and a steroid are equally effective in the treatment of ISSNHL when used together with HBO therapy. PGE1 plus HBO therapy can be one of the potential alternative treatments for ISSNHL, particularly in steroid-intolerant patients such as those with severe diabetes mellitus, an active peptic ulcer, or viral hepatitis.     

儿童突发性聋的临床特征及预后相关因素分析

目的 分析儿童突发性聋的临床特征、疗效及影响预后的相关因素,为临床治疗及预后评估提供依据。 方法 收集2010年1月至2017年10月就诊的67例突发性聋患儿临床资料,对其临床特征及治疗效果进行回顾性分析,同时根据疗效将患者分为总体有效组(36例)及无效组(31例),采用单因素及多因素分析的方法分析患者的性别、年龄、病程、初诊听阈、是否伴发耳鸣、眩晕、病毒感染史、发病季节和听力曲线类型对预后的影响。 结果 儿童突聋患者中64.18%在春冬季发病,其就诊时听阈为(76.62±25.97)dB HL,耳鸣及眩晕伴发率分别为70.15%和61.19%,病毒感染率为19.40%,听力曲线中10.44%为低频下降型、2.99%为高频下降型、34.33%为平坦型及52.24%为全聋型。经治疗后,患者听阈为(60.41±31.52)dB HL,总体有效率为53.73%,其中痊愈率、显效率及有效率分别为20.90%、16.42%和16.42%。多因素分析结果显示,初诊听阈越高及听力曲线为全聋型,预后越差(P均<0.05);伴有病毒感染的非全聋型患者预后较好(P<0.05)。 结论 儿童突发性聋患者病毒感染率较高且大部分在春冬季发病,就诊时听力损失较重并常伴有耳鸣及眩晕,其听力曲线以平坦型及全聋型为主。就诊时听力损伤程度轻、伴有病毒感染的非全聋型患者预后较好。     

Prognosis is predicted by early hearing improvement in patients with idiopathic sudden sensorineural hearing loss

The time-course of the recovery of the hearing level after treatment in 90 patients with idiopathic sudden sensorineural hearing loss was examined. The improvement rate calculated relative to the hearing level of the opposite ear was investigated to estimate the hearing recovery. Follow-up audiograms were performed once per week for 1 month after treatment and once per month thereafter. There were two groups that differed with respect to the characteristics of hearing recovery. One group showed an improvement rate of over 50% at 1-2 weeks and a good improvement rate at 3 months after treatment. In the other group, the improvement rate did not reach 50% at 1-2 weeks, and the improvement rate was poor at 3 months after treatment. The patients with improvement rates of over 50% at 1-2 weeks had earlier initial visits and had mild hearing loss, whereas the patients with profound hearing loss had improvement rates under 50% and poor long-term prognosis. We conclude that the improvement rate at 1-2 weeks after treatment predicts the long-term prognosis for recovery of hearing level in patients with sudden sensorineural hearing loss.     

Magnesium treatment for sudden hearing loss

Magnesium treatment has been repeatedly shown to reduce the incidence of both temporary and permanent noise-induced hearing loss. We hypothesized that it might also improve the permanent threshold shift in patients with acute-onset hearing loss. In a prospective, randomized, double-blind, placebo-controlled trial, 28 patients with idiopathic sudden sensorineural hearing loss were treated with either steroids and oral magnesium (study group) or steroids and a placebo (control group). Compared to the controls, the magnesium-treated group had a significantly higher proportion of patients with improved hearing (>10 dB hearing level) across all frequencies tested, and a significantly greater mean improvement in all frequencies. Analysis of the individual data confirmed that more patients treated with magnesium experienced hearing improvement, and at a larger magnitude, than control subjects. Magnesium is a relatively safe and convenient adjunct to steroid treatment for enhancing the improvement in hearing, especially in the low-tone range, in patients with sudden sensorineural hearing loss.     

Hyperbaric oxygen and steroid therapy for idiopathic sudden sensorineural hearing loss

In our controlled retrospective analysis of medical records in tertiary care academic medical center, we aimed to investigate the therapeutic effects of hyperbaric oxygen (HBO) therapy combined with steroid administration for idiopathic sudden sensorineural hearing loss (ISSNHL) in comparison with that of steroid administration alone. Our subjects were 130 consecutive inpatients with ISSNHL (hearing levels ≥40 dB; time from the onset of hearing loss to the start of treatment ≤30 days). Sixty-seven patients underwent HBO plus steroid therapy (HBO group), and 63 were given steroids alone (steroid group). Hearing recovery was evaluated by grade assessment and by the improvement in hearing compared to that in the unaffected contralateral ear. The cure rate and hearing improvement rate were not statistically different between the two groups; however, the recovery rate was significantly higher in the HBO group than in the steroid group (59.7% vs. 39.7%; P < 0.05). With regard to patients with initial hearing levels of ≥80 dB, the hearing improvement rate was significantly higher in the HBO group than in the steroid group (51.1 ± 7.0% vs. 27.1 ± 7.8%; P < 0.05), while in patients whose initial hearing levels were <80 dB, hearing outcomes were not statistically different between the two groups. In both the HBO and steroid groups, patients with initial hearing levels of <80 dB showed a better hearing improvement rate than those with initial hearing levels of ≥80 dB. In conclusion HBO therapy shows a significant additional effect in combination with steroid therapy for ISSNHL, particularly in patients with severe hearing loss.     

Hyperbaric oxygen in the treatment of sudden hearing loss

Treatment of idiopathic sudden hearing loss (SHL) is still a great problem for the physicians, due to the still unexplained etiopathogenesis of the disease. This retrospective study includes 115 patients with idiopathic SHL and compares two therapy regimens. Of the total number of patients, 51 had been primarily treated by hyperbaric oxygen (HBO) at 2.8 bar. The remaining 64 patients had been treated by pentoxifylline infusions in increasing and decreasing doses. Hearing thresholds were ascertained at the frequencies of 250, 500, 1,000, 2,000 and 4,000 Hz using pure-tone audiometry. The results after treatment showed a statistically significant improvement of hearing by 46.35 (SD +/-18.58) dB hearing level (HL) in the group of patients treated with HBO, compared with an improvement of hearing by 21.48 dB HL (SD +/-13.5) in the group of patients treated with pentoxifylline infusions (p < 0.001). Furthermore, hearing recovered to physiological values in 24 of 51 (47.1%) HBO-treated patients, compared to only 4 of 64 (6.2%) of the pentoxifylline-treated patients. Furthermore, after pentoxifylline treatment only 8/64 (12.5%) patients showed partial recovery, whereas after HBO therapy 21/51 (41.2%) patients improved up to a mild persistent hearing loss. This indicates strong evidence that HBO therapy is more effective in the treatment of idiopathic SHL than conventional rheological treatment. However, more prospective clinical trials should confirm the efficiency of HBO therapy and lead to its wider application.     

Topical steroid therapy using the Silverstein Microwick in sudden sensorineural hearing loss after failure of conventional treatment

CONCLUSIONS: Local administration of steroids to the inner ear through the round window route improves hearing in patients after failure of conventional therapy. OBJECTIVES: To determine if delivery of methylprednisolone to the round window can improve hearing after failure of conventional treatment for sudden sensorineural hearing loss (SSHL) administered for 10 days after the onset of the hearing loss. PATIENTS AND METHODS: A Silverstein microwick was placed in the round window niche under local anesthesia and endoscopic control, allowing self-administration of methylprednisolone twice a day for 3 weeks. Treated patients were compared to a control group composed of similar patients, treated with the same systemic regimen but who did not receive local therapy. RESULTS: Of the 12 patients enrolled in this nonrandomized prospective study, 8 patients showed an improvement of the pure tone average (PTA) and 4 remain stable. Of those who responded to perfusion, eight patients demonstrated a significant mean 24.5 +/- 12 dB improvement in PTA, and seven patients had a mean 17.5 +/- 18% improvement in discrimination, with five patients reaching 100% speech discrimination score (SDS). Patients in the control group did not show any improvement of the PTA.     

Can Intratympanic Dexamethasone Added to Systemic Steroids Improve Hearing Outcome in Patients With Sudden Deafness?

OBJECTIVE: To evaluate the therapeutic efficacy of intratympanic dexamethasone (ITD) injections added to systemic steroids in patients with idiopathic sudden sensorineural hearing loss (HL). MATERIALS AND METHODS: A total of 120 patients diagnosed with sudden HL were treated with ITD injections (0.3 mL on days 1, 3, and 5) plus 48 mg methylprednisolone (ITD group) or methylprednisolone alone (control group). RESULTS: The total recovery rate after the treatment was 73.3% in the ITD group and 70.0% in the control group. Although improvements in pure-tone average were the same in the two groups, the ITD group showed significantly better hearing improvement at 250 Hz than the control group. CONCLUSION: The addition of ITD to systemic steroids did not result in significant improvements in the treatment of idiopathic sudden HL.     

Basilar artery tortuosity as a predictive factor for the efficacy of heparin adjuvant therapy in unilateral idiopathic sudden sensorineural hearing loss

IntroductionCochlear ischemia is hypothesized as one of the major etiologies of idiopathic sudden sensorineural hearing loss. Therefore, anticoagulant therapies are designed to be beneficial in certain patients with this condition.ObjectiveThis study aimed to determine which patients with idiopathic sudden sensorineural hearing loss would benefit from heparin treatment as adjuvant therapy.MethodsIn total, 134 patients who underwent magnetic resonance imaging for unilateral idiopathic sudden sensorineural hearing loss at a tertiary referral hospital between January 2014 and December 2018 were included in this retrospective study. All patients received Intratympanic steroid injections or heparin therapy plus oral corticosteroids. Radiological parameters of the vertebrobasilar system and clinical data from pre- and post-treatment assessments were analyzed.ResultsMost patients (71.6%) had a tortuous basilar artery The 65 patients with severe-to-profound idiopathic sudden sensorineural hearing loss showed a significant relationship between idiopathic sudden sensorineural hearing loss laterality and basilar artery displacement to the opposite side (p = 0.036), while the 69 patients with mild-to-moderate idiopathic sudden sensorineural hearing loss did not (p = 0.950). Additionally, the degree of basilar artery tortuosity was significantly associated with the degree of hearing impairment in the severe-to-profound idiopathic sudden sensorineural hearing loss group (p = 0.015). When idiopathic sudden sensorineural hearing loss occurred on the opposite side to basilar artery displacement, the improvement of hearing was significantly greater in patients treated with heparin than in those treated with intratympanic steroids (p = 0.041).ConclusionIn a subset of patients with severe-to-profound idiopathic sudden sensorineural hearing loss, basilar artery tortuosity had a significant directional relationship with idiopathic sudden sensorineural hearing loss laterality. In these selected patients, a significant effect of heparin therapy on improving hearing was observed.     

Coenzyme Q10 in combination with steroid therapy for treatment of sudden sensorineural hearing loss: a controlled prospective study

Clin. Otolaryngol. 2010, 35 , 486–489 Objective: To evaluate the therapeutic efficacy of coenzyme Q10 added to systemic steroid in patients with idiopathic sudden sensorineural hearing loss. Design: A controlled prospective study. Setting: Asan medical center, University of Ulsan College of Medicine. Participants: Between August 2007 and October 2008, the first 60 patients diagnosed with sudden sensorineural hearing loss were managed with systemic steroid treatment for 2 weeks including 5-day hospitalisation. And the second 60 patients were managed with coenzyme Q10 for 2 weeks added to previous management. Main outcome measures: We evaluated auditory function by pure tone audiometry and speech discrimination score. Auditory evaluations were performed before and 3 months after treatment using Siegel’s criteria. The degree of improvement in four-tone average hearing and speech discrimination score was calculated from the results before and after treatment. Results: The total hearing improvement rate after the treatment was 75.0% (90/120 patients) in this study. Although 47 patients (78.3%) of coenzyme Q10 group showed better hearing improvement than 43 patients (71.7%) of control group, there was no significant difference. However, the coenzyme Q10 group showed significantly higher improvement in speech discrimination score. Conclusion: From this study, we suggest that coenzyme Q10 may have beneficial effects in the treatment of sudden sensorineural hearing loss.     

鼓室内灌注醋酸泼尼松龙治疗主观性耳鸣的临床观察

目的探讨鼓室内灌注激素时主观性耳鸣的治疗效果。方法选择病史在1月以上已接受过口服药物治疗的耳鸣患者49例(55耳),随机分为治疗组29例(30耳),鼓室内注入醋酸泼尼松龙,同时口服扩血管药及维生素;对照组20例(25耳),仅口服扩血管药及维生素,观察两组治疗前后耳鸣的变化。结果治疗组中,耳鸣伴突发性聋14耳、老年性聋3耳、噪声性聋2耳、耳硬化症1耳,原因尚不能明确的感音性聋5耳,混合性聋2耳及传导性聋1耳,特发性耳鸣2耳。经过一个疗程的治疗后,耳鸣消失5耳,减轻11耳,有效率53.3%(16/30)。对照组中,仅6耳耳鸣响度减轻,有效率24%(6/25)。结论鼓室内应用皮质类固醇激素能改善主观性耳鸣。     

Transtympanic corticoid therapy for acute profound hearing loss

The prognosis of idiopathic sudden hearing loss depends on its severity; acute complete deafness, for example, has a particularly bad prognosis. The treatment of acute deafness is based on a systemic application of corticosteroids. Corticoid concentrations in the cochlea are higher after transtympanic application in comparison to systemic application. We therefore investigated whether an additional transtympanic corticoid therapy gives an advantage over systemic standard therapy. We report on 27 patients with sudden idiopathic profound hearing loss or deafness who were treated in the Department of Otorhinolaryngology, University of Essen, Germany. Fourteen patients were treated with a rheologic infusion therapy with systemic prednisolone. Thirteen patients were treated additionally with methylprednisolone (Urbason) transtympanically through a ventilation tube. In the first group of patients who were treated with infusion therapy and corticoids systemically, three patients had good recovery of hearing. Another five patients had a partial recovery of hearing. The average hearing gain from 0.5–4 kHz was 15 dB. In the group of patients who were treated additionally with local corticoids, two patients reported a good recovery of hearing and another two patients only had a partial recovery of hearing. The average hearing gain in the above-mentioned frequency range was 11 dB. In our patients the additional transtympanic application of corticoids did not result in a significantly improved recovery of hearing in comparison to the patients treated with the standard therapy alone.     

Idiopathic sudden sensorineural hearing loss in the only hearing ear: patient characteristics and hearing outcome

OBJECTIVE: To determine the otological outcome in patients with idiopathic sudden sensorineural hearing loss (ISSHL) in their only hearing ear. DESIGN: Retrospective medical chart review study. SETTING: Tertiary care hospital. PATIENTS: Forty-five consecutive patients older than 18 years with sudden sensorineural hearing loss during a 10 year period (1985-1995), 9 of whom had ISSHL in their only hearing ear. INTERVENTION: Daily audiometric tests, oral prednisolone (full available dose), and bed rest for at least a week. MAIN OUTCOME MEASURE: The audiometric result 7 to 10 days following the start of treatment was used as the treatment outcome. RESULTS: Demographic characteristics were not significantly different between patients with ISSHL whose contralateral ear is deaf and those whose contralateral ear hears well. A tendency to seek help sooner (2.8 +/- 1.4 vs 7.1 +/- 5.2 days [mean +/- SD], respectively) was noted. The mean +/- SD improvement of hearing in the 3 more affected frequencies was 13 +/- 13.4 dB for the investigated group compared with 9 +/- 8.7dB for the rest of the patients (not statistically significant). Of the 9 patients who previously had sensorineural hearing loss in the opposite ear, 5 showed end results of speech reception thresholds of 35 dB or better, as did 13 of the 36 patients in the other group. CONCLUSIONS: Patients with ISSHL in their only hearing ear may be treated the same way as other patients because their outcome appears to be the same. About 50% of the patients will have a 10 dB or more hearing improvement, and about 60% of patients in the investigated group will regain useful hearing.