Effect of Alprostadil Plus Ginkgo Biloba Extract on Hearing and Quality of Life in Sudden Sensorineural Hearing Loss:...

Sudden sensorineural hearing loss is associated with inner-ear microcirculatory disturbance and oxidative stress, which can damage auditory cells and cause permanent hearing impairment without timely treatment. Current management targets blood supply and inflammation, but single-agent efficacy remains unstable. This retrospective study explored whether alprostadil combined with Ginkgo biloba extract is associated with improved audiological outcomes and quality of life. Patients treated from January 2024 to December 2024 at a single center were included. A total of 100 patients who met the eligibility criteria were identified and divided into two groups based on their actual treatment: 50 who received alprostadil alone (control group) and 50 who received alprostadil plus Ginkgo biloba extract (combination therapy group). Primary outcomes were changes in affected-ear pure-tone average threshold [four-frequency pure-tone average (PTA-4)] and quality-of-life scales [36-Item Short Form Health Survey (SF-36); Hearing Handicap Inventory for Adults (HHIA)]. Assessments were performed before treatment and at follow-up as documented in the medical records. Statistical analyses included repeated-measures analysis of variance and independent-samples t-tests, with Bonferroni correction when required (α = 0.05/k), and adverse events (AE) were compared using the χ² test or Fisher's exact test. The PTA-4 group × time interaction was significant (P = 0.002). On day 90, PTA-4 improvement was greater in the combination therapy group than in the control group (P = 0.002). After 90 days, the proportion of mild hearing loss differed between groups (P = 0.040), whereas the proportions for other grades did not. Significant group × time interactions were observed for all SF-36 dimensions (all P < 0.05) and HHIA scores (P = 0.007). On days 10, 30, and 90, HHIA improved more in the combination therapy group; SF-36 scores were also higher at follow-up. All included patients had completed treatment and 90-day follow-up per medical records and were included in the efficacy and safety analyses. Alprostadil plus Ginkgo biloba extract improved short-term audiological and quality-of-life outcomes without increasing adverse reactions, supporting the short-term potential of early combination therapy.