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Steroid treatment for sudden hearing loss under the scanner

Steroid treatment for sudden hearing loss under the scanner According to a systematic review and meta-analysis both published in an issue of Archives of Otolaryngology, Head & Neck Surgery, steroids cannot be considered to be useful for treating patients with sudden hearing loss even though they are presently recommended for such patients.

Sudden sensorineural hearing loss is a hearing impairment complication that is characterized by hearing loss up to a minimum of 30 decibels over a minimum of three test frequencies in three days.

From News-Medical.Net:

For the systematic review, 21 trials were identified and evaluated, all of which used measures from hearing tests to define treatment outcomes. “Only two studies used identical criteria to define sudden sensorineural hearing loss,” the authors write. “The method of randomization was described in two studies. Validity scores ranged from two to eight (of nine). Positive results were reported favoring systemic steroids, intratympanic [inside the inner ear] steroids, batroxobin, magnesium, vitamin E and hyperbaric oxygen, although there were serious limitations in each study with a positive finding.”

This includes the article cited as the landmark study for the use of steroids, which was not described as a randomized trial and therefore may have produced exaggerated treatment effects, the authors note. The authors suggest that this study also used inconsistent doses of steroids and did not measure outcomes at the same time for all participants. “The study therefore does not inform the otolaryngologist of what dose of steroids to use, nor at what time after treatment to expect improvement,” the authors write.

Anne Elizabeth Conlin, B.A. & Sc., M.D., of the University of Ottawa, Ontario, and Lorne S. Parnes, M.D., F.R.C.S.C., of the University of Western Ontario, London, Canada, compiled data pertaining to all randomized clinical trials that were published between 1966-2006.

It was noted that systemic steroids cannot be considered to be the gold treatment standard for treating patients with sudden sensorineural hearing loss because of the severe complications of the landmark study supporting their use.

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