Competing treatments comparable for sudden hearing loss

A relatively new treatment for sudden hearing loss that involves injecting steroids into the middle ear appears to work just as well as the current standard of oral steroids, a study by researchers at Johns Hopkins and other institutions suggests. The findings, published in the May 25 Journal of the American Medical Association, could lead to more options for the 1 in 20,000 people who suffer from this often baffling and disabling condition each year.

As the name implies, sudden hearing loss (SHL) is a dramatic loss of hearing that occurs over a short period, usually less than 72 hours. Often, physicians never figure out the cause of the problem. Though about a third of patients regain some hearing on their own, others suffer a permanent loss if untreated. Patients are more likely to regain their hearing if they're treated within two weeks of the start of symptoms.

The usual treatment is a course of oral steroids, which are thought to reduce that might be responsible for the hearing loss. Some doctors have recently begun treating SHL patients instead with a series of steroid injections delivered through the and into the . In theory, these injections could deliver a heavier dose of steroids directly to the source of the problem, explains John Carey, M.D., a professor in the Department of Otolaryngology–Head and Neck Surgery at the Johns Hopkins University School of Medicine. However, he adds, the relative rarity of this condition and potential for it to improve without treatment left physicians puzzled over how these two treatments compare.

To investigate, he and his colleagues conducted a trial of the two different treatments at 16 academic medical centers across the country. The researchers randomly assigned 250 patients who came into these centers for SHL treatment to receive either a two-week course of oral steroids or four steroid injections spaced out over two weeks. Before treatment, these patients each had a 50-decibel or greater hearing loss in one of their ears.

Two months after treatment, the researchers tested the study subjects' hearing again. Results showed that patients treated with oral steroids had an average 30.7-decibel improvement in the affected ear, compared to a 28.7-decibel improvement in those treated with injections. The treatments were comparable for most patients, Carey explains, with the exception of patients with very severe (greater than 90 decibels), who tended to have better results with oral steroids.

He adds that both treatments have a variety of pros and cons. For example, oral steroids come with a host of side effects, including insomnia, weight gain and an increase in blood sugar, but have a low cost and can be taken conveniently at home. Steroid injections can avoid these side effects, but are expensive and potentially painful, and need to be performed in a doctor's office.

"This study suggests that for most SHL patients, oral and injected steroids appear to be equally effective," Carey says. "This could lead to better options for patients that match their personal preferences."

He and his colleagues plan to eventually study whether the treatments might be even more effective if they're give concurrently or sequentially.

Provided by Johns Hopkins Medical Institutions

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Evidence lacking to guide treatment for sudden hearing loss

Jun 18, 2007

Although steroids are the most widely used treatment for sudden hearing loss, little scientific evidence supports their use or that of any other therapies for this condition, according to a systematic review and meta-analysis ...

Study vindicates dual treatment regimen

Mar 01, 2011

A combination of oral and nasal steroids can significantly improve the treatment of chronic rhinosinusitis - a common and often debilitating form of sinusitis - and help avoid surgery, according to new research carried out ...

Steroid injections may slow diabetes-related eye disease

Dec 28, 2009

Researchers led by specialists at the Johns Hopkins Wilmer Eye Institute have found that injecting a corticosteroid, triamcinolone, directly into the eye may slow the progression of proliferative diabetic retinopathy, a complication ...

Recommended for you

Ebola: timeline of a ruthless killer

1 hour ago

Here are key dates in the current Ebola epidemic, the worst ever outbreak of the haemorrhagic fever which first surfaced in 1976 in the Democratic Republic of Congo (DRC).

Ebola reveals shortcomings of African solidarity

22 hours ago

As Africa's leaders meet in Ethiopia to discuss the Ebola crisis, expectations of firm action will be tempered by criticism over the continent's poor record in the early stages of the epidemic.

Second bird flu case confirmed in Canada

Jan 30, 2015

The husband of a Canadian who was diagnosed earlier this week with bird flu after returning from a trip to China has also tested positive for the virus, health officials said Friday.

What exactly is coronavirus?

Jan 30, 2015

The conflicts in Syria and Iraq are straining public health systems and public health efforts meant to prevent and detect the spread of infectious diseases. This is generating a "perfect storm" of conditions for outbreaks. Among the infections raising concern is Middle East Respiratory Syndrome, caused by a type of coronavirus, which emerged in 2012. ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.