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Real life safety of systemic steroids for sudden sensorineural hearing loss: a chart review

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objectives

To report adverse events (AEs) associated with systemic steroid treatment in idiopathic sudden sensorineural hearing loss (ISSNHL).

Material and methods

A retrospective chart review of consecutive patients newly diagnosed with ISSNHL necessitating systemic steroidal treatment was conducted from 1/2017 to 2/2021. Blood pressure (BP) was monitored three times daily and morning fasting glucose was monitored once daily during treatment. An AE was defined as a fasting blood glucose level > 160 mg/dl, systolic BP > 80 mmHg, and diastolic BP > 100 mmHg.

Results

In total, 143 patients were enrolled [69 (48%) males and 74 (52%) females] of whom 29 (20%) had diabetes mellitus (DM) and 46 (32%) had hypertension (HTN). The cohort’s median age (interquartile range) was 58 (37–69) years. Fifty-three patients (37%) did not complete the oral steroidal treatment due to any AE (glycemic or hypertensive). Background DM highly correlated with increased risk of a glycemic event (0.59 vs. 0.13 for diabetic and non-diabetic patients, respectively, P < 0.001). HTN correlated significantly with increased risk of an overall AE (0.54 vs. 0.29 for hypertensive and non-hypertensive patients, respectively, P = 0.001). Neither pre-treatment BP nor glucose level predicted the risk of an AE (P = 0.310 and 0.521, respectively).

Conclusions

AEs due to systemic steroidal treatment are common among ISSNHL patients. Demographic and baseline values cannot predict the risk of AEs which can occur throughout the entire duration of treatment. Patients with DM and HTN are at the greatest risk of AEs. Tight blood glucose and BP monitoring are recommended during treatment.

Level of evidence

4.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel

    Nir Halevy, Bshara Elias, Shahaf Shilo, Nidal Muhanna, Ophir Handzel, Yahav Oron, Rani Abu Eta & Omer J. Ungar

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Nir Halevy, Bshara Elias, Shahaf Shilo, Nidal Muhanna, Ophir Handzel, Yahav Oron, Rani Abu Eta & Omer J. Ungar

Authors
  1. Nir Halevy
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  2. Bshara Elias
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  3. Shahaf Shilo
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  4. Nidal Muhanna
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  5. Ophir Handzel
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  6. Yahav Oron
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  7. Rani Abu Eta
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  8. Omer J. Ungar
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Corresponding author

Correspondence to Omer J. Ungar.

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The authors have no financial conflicts of interest relevant to this article to disclose.

Ethical consideration

This study was approved by the local institutional review board (0312-19-TLV).

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This is an original manuscript reviewed by all authors and not under consideration for publication elsewhere.

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Halevy, N., Elias, B., Shilo, S. et al. Real life safety of systemic steroids for sudden sensorineural hearing loss: a chart review. Eur Arch Otorhinolaryngol 279, 4787–4792 (2022). https://doi.org/10.1007/s00405-022-07264-3

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  • DOI: https://doi.org/10.1007/s00405-022-07264-3

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