Sudden Unilateral Deafness – Get on Steroids ASAP

A recent review concludes it’s the result of an infectious or inflammatory condition. It also refers to fact steroids are the mainstay of treatment

Medical Hypothesis 122 (2019) 184-187.
Time and geographic clustering of adult patients with unilateral idiopathic sudden sensorineural hearing loss
Sapideh Gilani et al
https://www.sciencedirect.com/science/article/pii/S0306987718308107

Mainstay of treatment are steroids – either through eardrum or oral – each as effective and the latter easier to obtain though more prone to side effects

Dose was determined from this study:

Rauch SD, Halpin CF, Antonelli PJ, et al.
Oral vs Intratympanic Corticosteroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss: A Randomized Trial.
JAMA. 2011;305(20):2071–2079.
doi:10.1001/jama.2011.679
https://jamanetwork.com/journals/jama/fullarticle/900108

  • oral was 60 mg/d of oral prednisone for 14 days with a 5-day taper (have to warn re risk of osteonecrosis hip and need to up diabetic meds)
  • full recovery with oral was 20.7% (25 of 121)
  • recovery to hearing aid range with oral was 66.9%
  • oral “side effects” seen included myocardial infarction, cerebral hemorrhage, hyponatremia (low blood salt), hospitalization for possible transient ischemic attack, and syncope – though think some of it speak for fact these are older folk…

Comment – there is an ergency to get these people of steroids ASAP

 

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