Optimal First-Line Therapy for Acute Low-Tone Sensorineural Hearing Loss

• Published in: Journal of audiology & otology Vol. 25; no. 4; pp. 209 - 216
• Main Authors: Shin, Seung-Ho, Byun, Sung Wan, Park, Sohl, Kim, Eun Hye, Kim, Min Woo, Lee, Ho Yun
• Format: Journal Article
• Language: English
• Published: The Korean Audiological Society and Korean Otological Society 01-10-2021; 대한청각학회
• Subjects: Original; 이비인후과학
• ISSN: 2384-1621; 2384-1710
• DOI: 10.7874/jao.2021.00269

Background and Objectives: We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results.Subjects and Methods: We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital’s otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated.Results: Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results.Conclusions: A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.