A study on the effective corticosteroid dose to improve the hearing threshold in patients with idiopathic sudden sensorineural hearing loss

Corticosteroids have been applied historically for the treatment of idiopathic sudden sensorineural hearing loss (ISSHL). We analyzed the data of 58 patients who were diagnosed as having ISSHL at Kyoto University Hospital. Of the 58, 25 patients seen between March 2009 and April 2011, and 33 patients seen between May 2011 and December 2014 were treated with initial prednisolone doses of 200 mg and 100 mg (200 mg and 100 mg groups), respectively. The corticosteroid dose was tapered over 9 days in both groups. Hearing recovery was evaluated at 1 month after treatment completion by determination of the averaged pure-tone audiogram thresholds for five frequencies from 250 Hz to 4 kHz. In the 200-mg group, a 19.0-dB improvement in the averaged hearing threshold was seen, whereas in the 100-mg group, a 25.8-dB improvement in the hearing threshold was observed. Of the patients of the 200-mg group, 72.0% showed slight recovery and 20.0% showed marked recovery; on the other hand, in the 100-mg group, 78.8% showed slight recovery and 42.4% showed marked recovery. No statistically significant difference in the effect of treatment was observed between the two groups. Therefore, prednisolone treatment with a starting dose of 100 mg followed by tapering is preferable to that with a starting dose of 200 mg followed by tapering for patients with ISSHL.