Combined treatment of sudden sensorineural hearing loss with steroid, dextran and piracetam: experience with 68 cases

  • Erdal Samim
  • Rahmi Kılıc
  • Ali Ozdek
  • Hakan Gocmen
  • Adil Eryılmaz
  • Ilhan Unlu


The purpose of this study was to evaluate the effectiveness of our combined treatment regimen and to clarify the possible prognostic factors in sudden sensorineural hearing loss (SSNHL). In a retrospective chart review, the charts of 68 patients who matched the inclusion criteria of this study were evaluated. All patients were treated with a standard regimen including prednisone, dextran and piracetam between January 1998 and December 2001. Initial (at the beginning of therapy) and final (3 weeks after the beginning of therapy) audiograms were compared with respect to hearing improvement. Possible prognostic factors were also evaluated. Overall hearing improvement was determined as 54.4%. Sex was the only determined prognostic factor in this study. Females had a better prognosis. Our treatment regimen had no superiority to the reported spontaneous hearing recovery. Females seem to have a better prognosis.


Sudden sensorineural hearing loss Prognostic factors Combined therapy 


  1. 1.
    Alexiou C, Arnold W, Fauser C, Schratzenstaller B, Gloddek B, Fuhrmann S, Lamm K (2001) Sudden sensorineural hearing loss. Does application of glucocorticoids make sense? Arch Otolaryngol Head Neck Surg 127:253–258PubMedGoogle Scholar
  2. 2.
    Byl FM Jr (1984) Sudden hearing loss: 8-years experience and suggested prognostic table. Laryngoscope 94:647–661PubMedGoogle Scholar
  3. 3.
    Cinnamon U, Bendet E, Kronenberg J (2001) Steroids, carbogen or placebo for sudden hearing loss: a prospective double blind study. Eur Arch Otorhinolaryngol 258:477–480PubMedGoogle Scholar
  4. 4.
    Gersdorrf M, Franceschi D (1986) Value of piracetam in the treatment of sudden idiopathic deafness. Preliminary report. Ann Otolaryngol Chir Cervicofac 103:283–285PubMedGoogle Scholar
  5. 5.
    Gianoli GJ, Li JC (2001) Transtympanic steroids for treatment of sudden hearing loss. Otolaryngol Head Neck Surg 125:142–146CrossRefPubMedGoogle Scholar
  6. 6.
    Grandis JR, Hirsch BE, Wagener MM (1993) Treatment of idiopathic sudden sensorineural hearing loss. Am J Otol 14:183–185PubMedGoogle Scholar
  7. 7.
    Haberkamp TJ, Tanyeri H (1999) Management of idiopathic sudden sensorineural hearing loss. Am J Otol 20:587–595PubMedGoogle Scholar
  8. 8.
    Harris I (1984) Sudden hearing loss: membrane rupture. Am J Otol 5:484–487PubMedGoogle Scholar
  9. 9.
    Hickenbottom SL, Grotta J (1998) Neuroprotective therapy. Semin Neurol 18:485–492PubMedGoogle Scholar
  10. 10.
    Kronenberg J, Almagor M, Bendet E, Kushnir D (1992) Vasoactive therapy versus placebo in the treatnent of sudden hearing loss: a double-blind clinical study. Laryngoscope 102:65–68PubMedGoogle Scholar
  11. 11.
    Mann W, Beck C (1986) Calcium antagonists in the treatment of sudden deafness. Arch Otorhinolaryngol 243:170–173PubMedGoogle Scholar
  12. 12.
    Mattox DE, Simmons FB (1977) Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 86:463–480PubMedGoogle Scholar
  13. 13.
    Moskowitz D, Lee KJ, Smith HW (1984) Steroid use in idiopathic sudden sensorineural hearing loss. Laryngoscope 94:664–666PubMedGoogle Scholar
  14. 14.
    Redleaf MI, Bauer CA, Gantz BJ, Hoffman HT, Mccabe BF (1995) Diatrizoate and dextran treatment of sudden sensorineural hearing loss. Am J Otol 16:295–303PubMedGoogle Scholar
  15. 15.
    Schweinfurth JM, Parnes SM, Very M (1996) Current concepts in the diagnosis and treatment of sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 253:117–121PubMedGoogle Scholar
  16. 16.
    Simmons FB (1979) The double-membrane break syndrome in sudden hearing loss. Laryngoscope 89:59–64PubMedGoogle Scholar
  17. 17.
    Stockmans F, Deberdt W, Nystrom A, Nystrom E, Stassen JM, Vermylen J, Deckmyn H (1998) Inhibitory effect of piracetam on platelet-rich thrombus formation in an animal model. Thromb Haemost. 79:222–227Google Scholar
  18. 18.
    Tucci DL, Farmer JC Jr, Kitch RD, Witsell DL (2002) Treatment of sudden sensorineural hearing loss with systemic steroids and valacyclovir. Otol Neurotol 23:301–308PubMedGoogle Scholar
  19. 19.
    Whitaker S (1980) Idiopathic sudden hearing loss. Am J Otol 1:180–183PubMedGoogle Scholar
  20. 20.
    Wilkins SA, Mattox DE, Lyles A (1987) Evaluation of a shotgun regimen for sudden hearing loss. Otolaryngol Head Neck Surg 97:474–480PubMedGoogle Scholar
  21. 21.
    Wilson WR, Byl FM, Laird N (1980) The efficacy of steroids in the treatment of idiopathic sudden hearing loss. Arch Otolaryngol Head Neck Surg 106:772–776Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Erdal Samim
    • 1
  • Rahmi Kılıc
    • 1
  • Ali Ozdek
    • 1
    • 3
  • Hakan Gocmen
    • 1
  • Adil Eryılmaz
    • 2
  • Ilhan Unlu
    • 1
  1. 1.Department of Ear, Nose and ThroatMinistry of Health Research and Training HospitalAnkaraTurkey
  2. 2.Third Ear, Nose and Throat DepartmentMinistry of Health Ankara Numune Research and Training HospitalAnkaraTurkey
  3. 3.AnkaraTurkey

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