Efficacy and Side Effect of Different Doses of Glucocorticoids on Sudden Deafness

Abstract

Background

Sudden deafness (SD) presents as rapid-onset sensorineural hearing loss within 72 hours, with unknown etiology. Current guidelines recommend systemic corticosteroids as first-line therapy, though high-dose regimens may increase risks of hypertension and hyperglycemia. No consensus exists on optimal SD treatment protocols.

Objective

To compare the treatment efficacy and side effects of different doses of glucocorticoids in patients with sudden deafness.

Methods

A total of 248 patients (from July 2020 to May 2022) with sudden deafness were divided into 3 groups based on their initial dexamethasone dosages: group A (adequate dose, 10 mg/d), group B (high dose, 15 mg/d), and group C (high dose, 20 mg/d). For treatment efficacy, the mean hearing threshold elevation was subsequently evaluated. For side effects, blood glucose and blood pressure were monitored in 14 patients with sudden deafness accompanied by diabetes and 20 patients with concomitant primary hypertension.

Results

There was no significant difference in the efficacy of various initial corticosteroid doses among different subgroups (all P > 0.05). Higher initial doses were associated with increased risk of rapid glucose in patients with diabetes, whereas no significant difference was observed in blood pressure fluctuation among the 3 groups.

Conclusions

The treatment efficacy of the 3 different corticosteroid doses in sudden deafness treatment was comparable; yet, an increased risk of rapid blood glucose increase was accompanied by the elevated dose of dexamethasone in patients with diabetes. Therefore, an adequate glucocorticoid (dexamethasone, 10 mg/d) could be the optimal regimen of patients with sudden deafness and diabetes.