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Comparison of the outcomes of treatment with an oral diuretics with steroid and steroid only for acute low-tone hearing loss: a prospective randomized controlled trial
Seok Min Hong, Yeso Choi, Sung Min Park, Jae Yong Byun
Res Vestib Sci. 2024;23(3):95-100.   Published online September 15, 2024
DOI: https://doi.org/10.21790/rvs.2024.012
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AbstractAbstract PDF
Objectives
This study aimed to compare the efficacy of a combined steroid and diuretic (isosorbide) treatment with that of steroid-only treatment in patients with acute low-tone sensorineural hearing loss (ALHL).
Methods
A total of 34 patients with ALHL were recruited between January 2018 and December 2019 and randomized into two groups: a steroid-with-diuretic (isosorbide) group and a steroid-only group. The steroid-with-diuretic group received oral methylprednisolone for 10 days and isosorbide for 14 days, while the steroid-only group received methylprednisolone for 10 days. Hearing outcomes were measured using pure-tone audiometry at 8 weeks posttreatment. The outcomes were the absolute hearing gain at low frequencies (125, 250, and 500 Hz) and the recovery rate, which was classified into complete, partial, unchanged, progressive, and fluctuating.
Results
Of 34 patients, 30 (15 in each group) were analyzed. No significant differences were observed in baseline characteristics between the groups. The steroid-with-diuretic group showed higher absolute hearing gains at all three low frequencies than the steroid-only group, but the differences were not statistically significant complete recovery was observed in 13 patients in each group, with partial recovery in two patients in the steroid-with-diuretic group and unchanged outcomes in two patients in the steroid-only group. No patient exhibited disease progression.
Conclusions
Although combined steroid and diuretic therapy yielded better hearing outcomes than steroid-only therapy, the differences were not statistically significant. Further studies with larger sample sizes and extended follow-up periods are necessary to confirm these findings.
Comparison of Treatment Outcomes between Intratympanic Steroid Injection and Oral Diuretics in Patients with Acute Low Frequency Sensorineural Hearing Loss with Vertigo
Yong-Hwi An, Hyun Joon Shim
Res Vestib Sci. 2019;18(4):111-117.   Published online December 15, 2019
DOI: https://doi.org/10.21790/rvs.2019.18.4.111
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AbstractAbstract PDF
Objectives
Sudden sensorineural hearing loss and Meniere disease can be managed with intratympanic steroid injection (ITSI) as a primary treatment. The aim of this study was to compare the effectiveness of ITSI versus oral diuretics for acute low frequency sensorineural hearing loss (LFHL) with vertigo.
Methods
A total 76 patients with LFHL that had developed within previous 2 weeks were enrolled and categorized into 2 groups: treated with ITSI four times on 4 consecutive days (ITSI group; 42 patients) and treated with diuretics orally for 2 weeks (diuretics group; 34 patients). After 6 months, we analyzed treatment outcomes using subjective improvement and audiometric change.
Results
Hearing thresholds at low frequencies ≤500 Hz were significantly improved in both ITSI and diuretics group (p<0.05). The cure rate of ITSI group was not significantly higher than that of diuretics group (54.8% vs. 52.9%, p>0.05). For subjective symptoms, there were no significant differences of improvement rate in both groups (ITSI 64.3% vs. diuretics 61.8%, p>0.05). In pure tone audiometry, the improvement rate of ITSI group was not significantly different from that of diuretics group (78.6% vs. 70.6%, p>0.05). There was a significant correlation between the cure rate and duration of symptoms.
Conclusions
Both ITSI and diuretics are effective treatment modalities for acute LFHL with vertigo within 2 weeks of development. There is no difference of treatment outcomes between ITSI and diuretics in patients with acute LFHL and vertigo.
Intratympanic Steroid Treatment versus Intratympanic Steroid and Diuretics Combination Treatment in Patients with Acute Low Frequency Sensorineural Hearing Loss with Vertigo
Hyeon Sik Oh, Hyun Joon Shim, Yong-Hwi An
Res Vestib Sci. 2017;16(3):85-91.   Published online September 15, 2017
DOI: https://doi.org/10.21790/rvs.2017.16.3.85
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AbstractAbstract PDF
Objectives
Intratympanic dexamethasone (ITD) is a standard treatment for patients with sudden sensorineural hearing loss. The aim of this study was to evaluate the effectiveness of ITD vs. combination of ITD and diuretics for acute low frequency sensorineural hearing loss (LFHL) with vertigo. Methods: A total 31 patients with LFHL that had developed within previous 2 weeks were enrolled and categorized into two groups: treated with ITD four times on 4 consecutive days (ITD group; 17 patients) and treated with ITD in the same way and diuretics orally for 2 weeks (combination group; 14 patients). After 6 months, we analyzed treatment outcomes using subjective improvement and audiometric change. Results: Hearing thresholds at low frequencies ≤500 Hz were significantly improved in both ITD only and combination group (p<0.05). The cure rate of combination group was not significantly higher than that of ITD only group (57.1% vs. 52.9%, p>0.05). For subjective symptoms, there were no significant differences of improvement rate in both groups (combination 64.3% vs. ITD only 64.7%, p>0.05). In pure tone audiometry, the improvement rate of combination group was not significantly different from that of ITD only group (71.4% vs. 76.5%, p>0.05). There was a significant correlation between the complete recovery rate and duration of symptoms. Conclusion: ITD alone is an effective treatment modality for acute LFHL with vertigo within 2 weeks of development. Combined ITD and diuretics have no additive effect for the recovery of hearing in patients with LFHL.

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