[The effects of high-dose steroid therapy on sudden deafness]

The effect of high-dose steroid therapy on sudden deafness were investigated in 19 cases. A daily intravenous administration dose of hydrocortisone sodium succinate was tapered from 800 mg to 200 mg as follows; 800 mg 800 mg, 600 mg, 600 mg, 400 mg, 400 mg, 300 mg, and 200 mg. Another 19 cases, the control group, were treated with intravenous application of prednisolone, tapered from 50 mg to 10 mg in 10-mg steps and each dose applied for 3 days. There were no significant differences in the effect on hearing between the two groups as measured by three different analyses: criteria proposed by the Committee on Sudden Deafness of the Japan Health Ministry; magnitudes of improvement of mean thresholds at five frequencies from 250 Hz to 4 kHz in affected side; and the ratio of the magnitudes of improvement of mean thresholds in affected side to magnitudes of difference between the initial mean thresholds in affected side and those in contralateral side. These findings suggest that high-dose steroid therapy for sudden deafness is not so effective as it is for idiopathic facial palsy. This may be due to the difference in the mechanisms of development between the two conditions. No critical side effects were observed in our study, which would argue for the safety of our method of high-dose steroid therapy for routine clinical use. It might be advisable to conduct additional clinical studies to determine the effect of high-dose steroid therapy for sudden deafness, because our study was conducted on a small number of patients and was not double-blind or randomized.