Nimodipine and Steroid Combination Therapy for Idiopathic Sudden Sensorineural Hearing Loss

초록

Objective: To evaluate the treatment outcomes of nimodipine and steroid combination therapy for idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: Seventy-eight patients who were diagnosed with ISSNHL were divided into two group based on the treatment strategies used: steroid+nimodipine (SN, n = 36) and steroid only (SO, n = 42) groups. Based on the level of hearing loss before treatment, subgroup analysis (<90 dB HL, SN-S versus SO-S groups; >= 90 dB HL, SN-P versus SO-P groups) was performed. Interventions: Nimodipine+dexamethasone versus dexamethasone alone. Main Outcome Measures: Hearing thresholds and complete/partial recovery rate after treatment. Results: Hearing thresholds after treatment were not significantly different between the SN and SO groups (46.8 +/- 29.4 versus 54.8 +/- 27.6 dB HL, p = 0.218). However, the complete recovery rate was significantly higher in the SN group than in the SO group ( 41.7% versus 16.8%, p = 0.014). In subgroup analysis, the complete recovery rate was significantly higher in the SN-S group than in the SO-S group (60.9% versus 19.2%, p = 0.003), whereas the difference between the SN-P and SO-P groups was not significant (7.7% versus 12.5%, p = 0.672). The cumulative incidence of complete recovery was significantly higher in SN-S group than in the SO-S group (p = 0.005); the mean recovery time was 4.4 weeks (95% confidence interval [CI], 2.8-6.1) in the SN-S group and 8.8 weeks (95% CI, 7.0-10.5) in the SO-S group. Conclusions: The results of this study suggest that nimodipine and steroid combination therapy for ISSNHL results in a higher complete recovery rate than steroid alone in patients with moderate to severe hearing loss.

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