Sudden Hearing Loss Medication

Updated: Apr 26, 2017
  • Author: Neeraj N Mathur, MBBS, MS, DNB(ENT), MNAMS, FAMS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Medication

Medication Summary

No high-quality, randomized, controlled trial exists demonstrating the efficacy of any medical therapy in ISSHL. Hence, no single treatment has been unequivocally shown to be effective, but many strategies have been proposed. Carbogen (5% CO2 +95% oxygen) inhaled for 30 min, 6 times per day (q2h during the day) for 5 days has been used. [23]

A prospective, randomized, noninferiority trial compared the effectiveness of oral prednisone with the effectiveness of intratympanic methylprednisolone in 250 participants with idiopathic sudden sensorineural hearing loss. After 6-month follow-up, the results indicated that based on hearing level 2 months after treatment, the treatments showed similar overall efficacy. [24]

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Corticosteroids

Class Summary

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.

Prednisone (Orasone, Meticorten, Deltasone, Wysolone)

May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity.

Dexamethasone (Decadron)

Intratympanic dexamethasone increases cochlear blood flow after ischemia-induced injury.

Has many pharmacologic benefits but significant adverse effects. Stabilizes cell and lysosomal membranes, increases surfactant synthesis, inhibits prostaglandin and proinflammatory cytokines (eg, TNF-alpha, IL-6, IL-2, and IFN-gamma). The inhibition of chemotactic factors and factors that increase capillary permeability inhibits recruitment of inflammatory cells into affected areas. Suppresses lymphocyte proliferation through direct cytolysis and inhibits mitosis. Breaks down granulocyte aggregates, and improves pulmonary microcirculation. Adverse effects are hyperglycemia, hypertension, weight loss, GI bleeding or perforation synthesis, cerebral palsy, adrenal suppression, and death. Most of the adverse effects of corticosteroids are dose-dependent or duration-dependent.

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Diuretics

Class Summary

These agents are beneficial in the treatment of fluid retention.

Hydrochlorothiazide/triamterene (Dyazide, Maxzide)

Inhibits reabsorption of sodium in distal tubules, causing increased excretion of sodium and water as well as potassium and hydrogen ions.

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Skin and mucus membrane agents

Class Summary

Agents in this category may help in the dispersion and absorption of drugs.

Hyaluronidase (Hylase, Wydase Injection)

Stimulates hydrolysis of hyaluronic acid, one of the chief ingredients of tissue cement, which offers resistance to diffusion of liquids through tissues. Used to aid in absorption and dispersion of injected drugs

Intratympanic hyaluronic acid may increase permeability of membranes and influences distribution of dexamethasone within inner ear.

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