Abstract

OBJECTIVE: Idiopathic sudden sensorineural hearing loss (ISSNHL) or sudden deafness is considered an otologic emergency. In spite of numerous investigations, its cause and treatment remain uncertain. Vascular hypothesis is one of the accepted etiologic theories, and vasodilator agents have been used to treat this medical condition.

MATERIALS and METHODS: We conducted a retrospective study in which we have compared the efficiency of two vasoactive/vasodilative agents-pentoxifylline and betahistine-separately and together for treatment of sudden deafness in 59 patients. Methylprednisolone was used in all three groups. Hearing threshold (HT) was measured, and pure tone average (PTA) was calculated on admission, after 1 week, and after 3 months.

RESULTS: Hearing improvement was noticed in 33 out of 59 patients (56%) at the second follow-up with a mean PTA improvement of 20 dB. The best recovery rate was seen in the pentoxifylline + steroid group (69%) versus the pentoxifylline + betahistine + steroid group (55%) and betahistine + steroid group (48%). There was no statistically significant difference in treatment outcome (p=0.433) between all three groups. Methylprednisolone dosage was 32, 48, or 64 mg/day. The amount of steroid given was not statistically significant for recovery of hearing loss (HL) (p=0.418).

CONCLUSION: The pentoxifylline with methylprednisolone group achieved the best results. In that group, 67% of patients improved at the first follow-up versus 69% after 3 months. Statistically, there was no significant difference in treatment outcome between all three groups (p=0.433). Greater PTA improvement was seen at higher doses of steroid. The amount of steroid given was not found to have a statistically significant influence on hearing recovery (p=0.418).