J Audiol Otol.  2021 Oct;25(4):209-216. 10.7874/jao.2021.00269.

Optimal First-Line Therapy for Acute Low-Tone Sensorineural Hearing Loss

• Shin SH
• Byun SW
• Park S
• Kim EH
• Kim MW
• Lee HY

• KMID: 2521618
• DOI: http://doi.org/10.7874/jao.2021.00269

Abstract

Background and Objectives
We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results.
Subjects and Methods
We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital’s otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated.
Results
Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results.
Conclusions
A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.

Keyword

Hearing loss; Sudden; Meniere disease; Treatment outcome; Prognosis; Steroids