Efficacy of combination therapy in adolescent and adult patients with total-deafness sudden sensorineural hearing loss

IntroductionThe mainstay of treatment for idiopathic sudden sensorineural hearing loss (SSNHL) includes oral steroids, intratympanic steroid injections or a combination of both. The National Institute for Health and Care Excellence, in their recent hearing loss guidelines, highlighted the paucity of evidence assessing the comparative effectiveness of these treatments; and the National Institute for Health Research (NIHR) Health Technology Assessment Programme has since released a commissioned call for a trial to identify the most effective route of administration of steroids as a first-line treatment for idiopathic SSNHL. For such trials to be run effectively, reliable information is needed on patients with SSNHL: where they present, numbers, demographics, treatment pathways, as well as outcomes. This study will collect these data in a nationwide cohort study of patients presenting with SSNHL across 97 National Health Service (NHS) trusts. The study will be delivered through ear, nose and throat (ENT) trainee networks, the NIHR Clinical Research Network (CRN) Audiology Champions and the NIHR CRN. Importantly, this study will also provide a dataset to develop a prognostic model to predict recovery for patients with idiopathic SSNHL. The study objectives are to: (1) map the patient pathway and identify the characteristics of adult patients presenting to NHS ENT and hearing services with SSNHL, (2) develop a prognostic model to predict recovery for patients with idiopathic SSNHL and (3) establish the impact of idiopathic SSNHL on patients’ quality of life (QoL).Methods and analysisStudy design: national multicentre prospective cohort study across 97 NHS trusts.Inclusion criteria: adult patients presenting to NHS ENT and hearing services with SSNHL.Outcomes: change in auditory function; change in QoL score.Analysis: multivariable prognostic model, using prespecified candidate predictors. Mean change in QoL scores will be calculated from initial presentation to follow-up.Ethics and disseminationHealth Research Authority and NHS Research Ethics Committee approved the study. Publication will be on behalf of study sites and collaborators.Trial registration numberClinicalTrials.gov Registry (NCT04108598).

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Potential Benefits of Combination Therapy as Primary Treatment for Sudden Sensorineural Hearing Loss

Otolaryngology ◽

10.1177/0194599815615121 ◽

2015 ◽

Vol 154 (2) ◽

pp. 328-334 ◽

Cited By ~ 10

Author(s):

Jong Bin Lee ◽

Seong Jun Choi

Keyword(s):

Hearing Loss ◽

Combination Therapy ◽

Sensorineural Hearing Loss ◽

Primary Treatment ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Potential Benefits

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Combination Therapy for Sudden Sensorineural Hearing Loss

Otolaryngology ◽

10.1016/j.otohns.2009.06.232 ◽

2009 ◽

Vol 141 (2_suppl) ◽

pp. P76-P76

Author(s):

Alex Battaglia ◽

Roberto Cueva ◽

Raoul Burchette

Keyword(s):

Hearing Loss ◽

Combination Therapy ◽

Sensorineural Hearing Loss ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing

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Welche Behandlung wirkt beim Hörsturz am besten?

Laryngo-Rhino-Otologie ◽

10.1055/a-0621-2081 ◽

2018 ◽

Vol 97 (07) ◽

pp. 448-449

Author(s):

Volker Schartinger

Keyword(s):

Randomized Controlled Trial ◽

Hearing Loss ◽

Combination Therapy ◽

Sensorineural Hearing Loss ◽

Systemic Therapy ◽

Controlled Trial ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Randomized Controlled

Ashtiani MK at al. Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: a randomized controlled trial. Eur Arch Otorhinolaryngol 2018; 275: 89–7 Iranische HNO-Ärzte verglichen die Heilungsraten einer Behandlung des idiopathischen Hörsturzes mit oralen und intratympanalen Kortikosteroidgaben in Mono- und Kombinationstherapien.

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Effect of Antioxidant Vitamins as Adjuvant Therapy for Sudden Sensorineural Hearing Loss: Systematic Review Study

Audiology and Neurotology ◽

10.1159/000486274 ◽

2018 ◽

Vol 23 (1) ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Iman Ibrahim ◽

Anthony Zeitouni ◽

Sabrina Daniela da Silva

Keyword(s):

Hearing Loss ◽

Adjuvant Therapy ◽

Sensorineural Hearing Loss ◽

Conventional Treatment ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Antioxidant Vitamins ◽

Adult Patients ◽

Unknown Etiology ◽

Control Group

Importance: Sudden sensorineural hearing loss (SSNHL) is an otological emergency of unknown etiology. Recent reports showed that antioxidant drugs can benefit patients with SSNHL. This study attempted to evaluate the effect of adding antioxidant vitamins as an adjuvant therapy alongside with corticosteroids. Objective: To evaluate the effects of the 3 major antioxidant vitamins (A, C, and E) as an adjuvant therapy, administered with corticosteroids, for the treatment of SSNHL in adult patients (≥18 years). Data Sources: MEDLINE, EMBASE, PubMed, Web of Science and Cochrane electronic databases from January 1, 1995, through September 25, 2017. Study Selection: Published studies of adult patients who received antioxidant vitamins (A, C, E, or any combination of these vitamins) as an adjuvant therapy in addition to the regular treatment (corticosteroids) for SSNHL. Quality assessment was performed using the Cochrane Collaboration Tool for Assessing Risk of Bias. Data Extraction: Each study had a control group (conventional treatment + placebo) and a trial group (antioxidant vitamin(s) + conventional treatment). Results: From 446 manuscripts identified in the literature, 3 studies were included in the review with 279 patients. The most common vitamins used to treat SSNHL were the 3 major antioxidant vitamins A, C, and E, combined sometimes with other antioxidants such as selenium. Conclusions and Relevance: The success of the treatment is increased in patients who received antioxidant vitamins in combination with conventional therapy.

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