Association between glucocorticoid dosage and hearing recovery in sudden sensorineural hearing loss: A retrospective study

PURPOSE: Glucocorticoids constitute the primary treatment for sudden sensorineural hearing loss (SSNHL). However, no consensus has been reached on the dosage and duration of treatment. This research evaluated the effectiveness and safety of various glucocorticoid dosages and durations for the treatment of SSNHL. PATIENTS AND METHODS: A total of 207 SSNHL patients were retrospectively enrolled. Patients were categorized into effective and ineffective groups on the basis of varying treatment outcomes. The clinical characteristics, glucocorticoid therapy data (dose and course), and adverse effects were collected. Linear correlation and logistic regression analyses were conducted to assess the relationships between varying therapeutic doses and courses of glucocorticoids and the outcomes of SSNHL. RESULTS: Compared with the ineffective group, the effective group was significantly younger and had lower initial hearing levels (P < 0.05), whereas their cumulative and average therapeutic doses of methylprednisolone were significantly greater (P < 0.05). There was no significant difference in adverse effects between the two groups. Linear correlation analysis revealed a positive relationship between both the cumulative and average therapeutic doses of methylprednisolone and hearing recovery in SSNHL patients. Logistic regression analysis indicated that a high average therapeutic dose of methylprednisolone (OR = 9.848; 95% CI = 2.775-34.952; P < 0.05) was associated with a favorable outcome in SSNHL patients. A cumulative therapeutic dose of 600-800 mg of methylprednisolone is associated with favorable outcomes for SSNHL patients (P < 0.05), and increasing the dosage beyond this range does not increase treatment efficacy. CONCLUSION: This study found that a higher average daily dose (under 2 mg/kg/d) and a cumulative glucocorticoid dose of 600-800 mg were associated with favorable outcomes in SSNHL patients, with no significant increase in adverse effects.