A comparison of single-dose and multiple divided daily-dose oral steroids for sudden sensorineural hearing loss

• Published in: Brazilian journal of otorhinolaryngology 2019-11, Vol.85 (6), p.733-738
• Main Authors: Yu, Gun Hee, Choi, Yong-Jun, Jung, Hahn Jin, Lim, Yun-Sung, Park, Seok-Won, Cho, Chang Gun, Park, Joo Hyun
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adolescent; Adult; Aged; Audiometry, Pure-Tone; Dose; Esteroide; Female; Glucocorticoids - administration & dosage; Hearing Loss, Sensorineural - drug therapy; Hearing Loss, Sudden - drug therapy; Humans; Male; Methylprednisolone - administration & dosage; Middle Aged; Original; OTORHINOLARYNGOLOGY; Perda auditiva neurossensorial súbita; Prednisolone - administration & dosage; Regime; Regimen; Retrospective Studies; Steroid; Steroids - administration & dosage; Sudden sensorineural hearing loss; Treatment Outcome; Young Adult
• ISSN: 1808-8694; 1808-8686; 1808-8686
• DOI: 10.1016/j.bjorl.2018.06.001

Glucocorticoids are considered the first-line therapy for sudden sensorineural hearing loss. But there is currently no consensus on administering them as a single dose versus multiple divided daily doses. We aim to evaluate the treatment outcome of sudden sensorineural hearing loss between a single-dose and multiple divided daily doses of steroid treatment. A total of 94 patients who were diagnosed and treated for sudden sensorineural hearing loss and followed up for more than three months were reviewed retrospectively. Patients were divided into single-dose and multiple divided-dose groups, based on their medication regimens. Hearing thresholds were repeatedly measured: on the initial visit and 1 week, 1 month, and 3 months after the initial treatment. Treatment outcomes were analyzed by comparing hearing recovery rates and post-treatment audiometric changes. The hearing threshold was significantly reduced at three months post-treatment in both groups. The hearing recovery rate of the single-dose group was significantly higher than that of the multiple divided-dose groups. Audiometric changes showed no statistical difference either in pure tone threshold or speech discrimination. When oral steroids are indicated for sudden sensorineural hearing loss, both a single dose and multiple divided doses can be effective for treatment and have comparable results. However, the single-dose regimen seems to be more efficacious than the divided-dose regimen. Os glicocorticoides são considerados terapia de primeira linha para perda auditiva neurossensorial súbita. Contudo, atualmente não há consenso em como para administrá-los, se em dose única ou múltiplas doses diárias. Nosso objetivo é avaliar o resultado do tratamento da perda auditiva neurossensorial súbita com uma dose única ou várias doses diárias de tratamento com esteróides. Um total de 94 pacientes que foram diagnosticados e tratados para perda auditiva neurossensorial súbita e acompanhados por mais de três meses pós-tratamento foram avaliados retrospectivamente. Os pacientes foram divididos em grupos de dose única diária e dose diária dividida em múltiplas tomadas, baseado em seu regime medicamentoso. Os limiares auditivos foram medidos repetidamente: na visita inicial e em 1 semana, 1 mês e 3 meses após o tratamento inicial. Os resultados do tratamento foram analisados comparando-se as taxas de recuperação da audição e as alterações audiométricas pós-tratamento. O limiar auditivo foi significativamente redu