A Comparison of Intravenous Pulse Methylprednisolone and Intravenous Dexamethasone on Idiopathic Sudden Sensorineural Hearing Loss: A Double-Blind Randomized Controlled Trial

Sirinkarn Sookdee¹, Penmas Teeravanittrakul¹, Narit Jianbunjongkit¹

Affiliation : ¹ Department of Otorhinolaryngology, Faculty of Medicine, Burapha University, Chonburi, Thailand

Objective: To evaluate the treatment success rate and safety of intravenous pulse methylprednisolone and dexamethasone treatment in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).
Materials and Methods: The present study was a double-blind randomized controlled trial. Twenty-eight patients who met the inclusion criteria were randomly divided into two groups, with 14 patients in each group. Group I patients were given intravenous pulse methylprednisolone 500 mg/day for the first three days and oral prednisolone 1 mg/kg/day for the next seven days, and Group II received intravenous dexamethasone 12 mg/day for the first three days and oral prednisolone 1 mg/kg/day for the next seven days. Pure-tone average (PTA) hearing threshold was recorded before and after treatment at third, tenth, and seventeenth day. The treatment success rate was hearing recovery level of patients whose PTA gain were 30 dB or more in each group as complete recovery and marked improvement. Audiologic improvement was classified according to the Furuhashi criteria.
Results: Treatment success rate was 64.29% with complete improvement at 35.71% and marked improvement at 28.57% in the methylprednisolone group, whereas it was 50.00% with complete improvement at 42.86% and marked improvement at 7.14% in the dexamethasone group at the seventeenth day follow-up visit. The treatment success rate was higher in the methylprednisolone group but not statistically significant. There was no significant difference of the side effect in both groups.
Conclusion: Intravenous pulse methylprednisolone is similar on treatment success rate and side effect to intravenous dexamethasone. Trial registration: Thai Clinical Trials Registry, TCTR20211224004

Received 7 February 2022 | Revised 29 April 2022 | Accepted 10 May 2022
DOI: 10.35755/jmedassocthai.2022.06.13328

Keywords : Idiopathic sudden sensorineural hearing loss; Steroid; Intravenous pulse methylprednisolone; Intravenous dexamethasone

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