The effect of initial treatment on hearing prognosis in idiopathic sudden sensorineural hearing loss: a nationwide survey in Japan

Abstract

Objective: To investigate the hearing prognosis of idiopathic sudden sensorineural hearing loss (SSNHL) treated with different initial therapies.

Methods: Subjects consisted of patients diagnosed with idiopathic SSNHL within 7 days from onset and showing severe hearing loss (≥60 dB), who were registered in a Japanese multicenter database between April 2014 and March 2016. Subjects were divided into four groups according to initial therapy: (1) steroids, (2) steroids + Prostaglandins (PGs), (3) intratympanic steroids (ITS), and (4) no steroids. Hearing outcomes were compared among the groups.

Results: In total, 1305 patients were enrolled. The final hearing level and hearing gain of patients treated with steroids + PGs were significantly higher than those of patients treated with steroids alone or no steroids. The ratio of good prognosis (complete recovery or marked improvement) in patients treated with steroids + PGs was higher than that in patients treated with steroids alone or no steroids. There was no difference in the prognosis of patients treated with steroids alone or no steroids.

Conclusion: A large number of patients with idiopathic SSNHL were registered in a multicenter database. PG use in combination with steroid administration was associated with a good hearing prognosis in patients with severe hearing loss.

Chinese abstract

目的: 探讨不同初始治疗对特发性突发感觉神经性听力损失 (SSNHL) 的听力预后。

方法: 在2014年4月至2016年3月期间, 受试者在日本的多中心数据库中注册。他们在发病后7天内诊断为特发性SSNHL并显示严重听力损失 (≥60dB) 。受试者根据初始治疗被分为四组: (1) 类固醇、 (2) 类固醇+前列腺素 (PG) 、 (3) 鼓室内类固醇 (ITS) 以及 (4) 无类固醇。在各组之间比较听力结果。

结果: 总共有1305例患者纳入该项研究。用类固醇+ PG治疗的患者的最终听力水平和听力增益显着高于只用类固醇或不用类固醇治疗的患者。用类固醇+ PG治疗的患者的良好预后 (完全恢复或显着改善) 的比率高于只用类固醇或不用类固醇治疗的患者。只用类固醇或不用类固醇治疗的患者的预后没有差异。

结论: 大量特发性SSNHL患者在多中心数据库中注册。 PG与类固醇联合使用与严重听力损失患者的良好的听力预后相关。

Keywords:

• Idiopathic sudden sensorineural hearing
• steroid
• prostaglandin
• intratympanic steroid injection

Acknowledgements

This study was supported by a Health and Labour Sciences Research Grant for Comprehensive Research on Disability Health and Welfare from the Ministry of Health, Labour and Welfare, Japan (http://www.mhlw.go.jp/english/) (S.U.).

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This study was supported by a Health and Labour Sciences Research Grant for Comprehensive Research on Disability Health and Welfare from the Ministry of Health, Labour and Welfare, Japan (http://www.mhlw.go.jp/english/) (S.U.).