An Analysis of Systemic Steroid Dosage in Idiopathic Sudden Sensorineural Hearing Loss

Objective: We retrospectively investigated whether the dosage of prednisolone (PSL) affects the response rate in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Design: Retrospective. Methods: A total of 159 patients diagnosed with initial ISSNHL and hospitalized between April 2007 and March 2021 at Yokosuka Kyosai Hospital were treated with systemic steroid therapy (SST) as a primary therapy and evaluated by pure-tone audiometry once a month. The cohort was comprised of 82 males and 77 females, with a mean age of 60.9 years old (range 16-83), consisting of 76 and 83 right and left ears, respectively. A total of 135 and 24 patients received SST with PSL dosage at 200 mg/day for 3 days with a 6-day taper and at 100 mg/day for 3 days with a 6-day taper, respectively. Results: In grades 1-2, there were no significant differences in the therapeutic response rates between the 2 groups; however, in grades 3-4, the response rate in the 200 mg PSL dosage group was significantly higher. We extracted dosage of PSL, age, time from onset to treatment, and vertigo as variables affecting the recovery rate, which was defined as the sum of the rate of complete recovery and marked improvement. Multivariate logistic regression analysis identified age and vertigo as significant variables influencing the recovery rate. Conclusion: Systemic steroid therapy with more than 100 mg/day of PSL with a taper for ISSNHL may not increase therapeutic efficacy in a dose-dependent manner. Keywords: Idiopathic sudden sensorineural hearing loss, systemic steroid therapy, prednisolone, primary therapy, multivariate logistic regression analysis