Pulse Steroid Therapy in Idiopathic Sudden Sensorineural Hearing Loss: A Randomized Controlled Clinical Trial

Objectives/Hypothesis: To evaluate in patients with idiopathic sensorineural hearing loss whether pulse therapy with methylprednisolone leads to better recovery of hearing than traditional oral prednisolone therapy. Study Design: Randomized controlled trial. Methods: Sixty-seven patients diagnosed with idiopathic sensorineural hearing loss were randomly divided into two groups based on therapy. The study group received 500-mg daily intravenous methylprednisolone for 3 consecutive days, followed by 1 mg/kg (maximum 60 mg) oral prednisolone for 11 days (total treatment: 14 days). The control group received 1 mg/kg (maximum 60 mg) oral prednisolone for 14 days. Hearing change was evaluated by comparing initial hearing tests and the third-month hearing tests in three ways: 1) pure tone improvement in each individual tone (0.5, 1, 2, 3, and 4 kHz); 2) word-recognition score improvement; and 3) complete, partial, and no recovery of hearing calculated (as defined by American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines). Results: Sixty of 67 patients, 29 of 34 patients in the study group and 31 of 33 patients in the control group, completed the study. Frequency-specific hearing improvement did not differ significantly among the groups. Word-recognition score improvement was 20.34% 627.35% for the study group and 13.41% 623.48% for the control group, which had no statistically significant difference. There was also no significant difference in hearing recovery rates for the two groups. Conclusion: Pulse therapy with methylprednisolone and traditional oral prednisolone therapy resulted in similar hearing improvement.