Treatment algorithm for idiopathic sudden sensorineural hearing loss based on epidemiologic surveys of a large Japanese cohort

Abstract

Background: To date, there have been few conventional algorithms for the treatment of idiopathic sudden sensorineural hearing loss (SSNHL), as there have been only limited reports with high evidence levels.

Objectives: To propose an evidence- and trend-based treatment algorithm for SSNHL.

Methods: We referred not only to the evidence for each treatment, but also to trends related to treatment selection in Japan based on epidemiologic surveys, and considered the balance of the advantages and disadvantages with regard to each patient’s condition.

Results: We propose an algorithm that begins with the grade of SSNHL severity as the prognosis of SSNHL is strongly related to the severity of hearing loss. We selected systemic corticosteroid therapy as the first-line therapy, and Intra-tympanic corticosteroid therapy as salvage therapy. We also proposed the use of prostaglandin E1 with corticosteroids for the treatment of SSNHL patients with severe hearing loss. According to the data obtained from an epidemiologic survey, we decided time limits for the application of each treatment.

Conclusion: An algorithm for the treatment for SSNHL is presented according to the results of epidemiologic surveys in Japan. It is expected that this algorithm can provide a guide to choosing the suitable treatment for SSNHL patients.

Chinese abstract

背景：迄今为止, 治疗特发性突发性感音神经性耳聋（SSNHL）的传统算法很少, 因为只有有限的高证据等级的报道。

目的：提出一种基于证据和趋势的SSNHL治疗算法。

方法：在流行病学调查的基础上, 我们不仅参考了每种治疗方法的证据, 还参考了日本治疗选择的相关趋势, 并考虑了对每个患者来说利弊之间的平衡。

结果：由于SSNHL的预后与听力损失的严重程度密切相关, 我们提出了一种从SSNHL严重程度分级开始的算法。我们选择全身皮质类固醇治疗作为一线治疗, 鼓室内皮质类固醇治疗作为补救治疗。我们还建议使用前列腺素E1和皮质类固醇治疗重度听力损失的SSNHL患者。根据流行病学调查获得的数据, 我们确定了每次治疗的应用时限。

结论：根据日本流行病学调查结果, 提出了一种SSNHL的治疗算法。该算法有望为SSNHL患者选择合适的治疗方案提供参考。

Keywords:

• Sudden sensorineural hearing loss
• algorithm
• epidemiological survey
• corticosteroids
• intra-tympanic
• prostaglandin E1

Disclosure statement

No potential conflicts of interest were reported by the authors.

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 of Japan (http://www.mhlw.go.jp/english/) (H29-Nanchito (Nan)-Ippan-031, S.U.).