Comparison of 3 Different Steroid Regimes for Idiopathic Sudden Sensorineural Hearing Loss: Trinidadian Experience

Abstract

Objectives:

Compare the efficacy of 3 steroid regimes in the management of idiopathic sudden sensorineural hearing loss (ISSNHL) in an adult population in Trinidad, West Indies, where management of this phenomenon has not previously been described.

Methods:

Retrospective review from 2005 to 2013 of 71 adults presenting with unilateral ISSNHL and treated within 72 hours of onset at a private general otolaryngology practice in Trinidad. Patients fell into 3 treatment groups: Group 1, oral prednisolone as the primary modality (n = 25); Group 2, oral prednisolone followed by salvage intratympanic methylprednisolone (n = 28); Group 3, intratympanic methylprednisolone as the primary modality (n = 18). Oral prednisolone was given as 60mg/d for 2 weeks and intratympanic methylprednisolone was given as 1 mL of a 40 mg/mL solution once weekly for 3 weeks.

Results:

Audiometric measurements were taken pre- and poststeroid therapy. Group 1: 50% (n = 13) of patients experienced an improvement in hearing (average 8 dB). Group 2: 22% (n = 6) of patients experienced an improvement in hearing (average 10 dB). Group 3: 88% (n = 16) of patients experienced an improvement in hearing (average 15 dB).

Conclusions:

The use of intratympanic methylprednisolone as a primary modality in ISSNHL is likely to be more beneficial than oral prednisolone or as salvage therapy following prednisolone. Early intervention is associated with more favorable outcomes.