Systemic steroids for sensorineural hearing loss
Reviewed by Sunil Sharma

This Japanese retrospective study looked at whether the dosage of prednisolone affects the response rate in patients with idiopathic sudden sensorineural hearing loss. The authors included a total of 159 patients over a 14-year period who were treated with 200mg/day of prednisolone for three days with a taper over six days, or 100mg/day of prednisolone for three days with a taper over six days, and had monthly pure tone audiograms. In univariate analysis, all thresholds and pure tone averages were significantly improved in the 200mg group compared to the 100mg group. In multivariate logistic regression analysis, the significant variables influencing the recovery rate were age and vertigo; however the dose of prednisolone was not significant. The authors report that no serious adverse events occurred and no patients ended the treatment early due to adverse events from prednisolone treatment. Therefore, treatment for idiopathic sensorineural hearing loss with more than 100mg/day of prednisolone with a taper does result in an increased therapeutic response but this does not seem to be related to increased prednisolone dosage. The authors did conclude that the presence of vertigo with sensorineural hearing loss had a poorer prognosis than without vertigo, which is something that has also been reported in the previous literature. There are few papers that have looked at the therapeutic efficacy of higher dose prednisolone and this paper suggests that it doesn’t work in a dose-dependent manner. This is interesting given that there is international variation in terms of what dose of systemic steroid is given.

An analysis of systemic steroid dosage in idiopathic sudden sensorineural hearing loss.
Hyakusoku H, Furukawa S, Aizawa Y, et al.
B-ENT
2024;20:7–12.