The effects of high-dose steroid therapy on sudden deafness

Abstract

The effect of high-dose steroid therapy on sudden deafness were investigated in 19 cases. A daily intravenous administration dose of hydrocortisone sodium succinate was tapered from 800mg to 200mg as follows; 800mg, 800mg, 600mg, 600mg, 400mg, 400mg, 300mg, and 200mg. Another 19 cases, the control group, were treated with intravenous application of prednisolone, tapered from 50mg to 10mg in 10-mg steps and each dose applied for 3 days. There were no significant differences in the effect on hearing between the two groups as measured by three different analyses: criteria proposed by the Committee on Sudden Deafness of the Japan Health Ministry; magnitudes of improvement of mean thresholds at five frequencies from 250Hz to 4kHz in affected side; and the ratio of the magnitudes of improvement of mean thresholds in affected side to magnitudes of difference between the initial mean thresholds in affected side and those in contralateral side. These findings suggest that high-dose steroid therapy for sudden deafness is not so effective as it is for idiopathic facial palsy. This may be due to the difference in the mechanisms of development between the two conditions. No critical side effects were observed in our study, which would argue for the safety of our method of high-dose steroid therapy for routine clinical use. It might be advisable to conduct additional clinical studies to determine the effect of high-dose steroid therapy for sudden deafness, because our study was conducted on a small number of patients and was not double-blind or randomized.