Optimal First-Line Therapy for Acute Low-Tone Sensorineural Hearing Loss

Area of Science:

• Otolaryngology
• Audiology
• Internal Medicine

Background:

• Acute low-tone sensorineural hearing loss (ALHL) requires effective management strategies.
• Understanding treatment outcomes for ALHL is crucial for clinical practice.

Purpose of the Study:

• To analyze treatment outcomes for ALHL based on initial management.
• To identify optimal treatment regimens for ALHL.

Main Methods:

• Retrospective analysis of 106 patients with ALHL.
• Evaluation of pure-tone averages at baseline, 2 weeks, and 4 weeks.
• Regression analysis to identify prognostic factors for recovery.

Main Results:

• Complete recovery (CR) was achieved in 83.7% at 2 weeks and 87.8% at 1 month.
• Diuretic use was associated with CR at 2 weeks (Exp(B): 10.309).
• Isolated diuretic use was an independent good prognostic factor for CR at 1 month (Exp(B): 25.641).

Conclusions:

• Initial daily low-dose prednisolone (≤30 mg) combined with diuretics is sufficient as a first-line treatment for ALHL.
• High-dose steroids and salvage intratympanic steroid injections may be considered but have a less favorable predicted outcome.
• Diuretics are a key component for successful ALHL management.