Clinical Trial on Treatment for Sudden Deafness

Editor: If you've ever known anyone who has suffered sudden hearing loss, you know that it's a pretty traumatic experience. The treatment of choice seems to be steroids, but it's not clear which delivery method works better. So here's a study to determine that!

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May 2008

NIDCD-funded scientists at the Massachusetts Eye and Ear Infirmary (MEEI), and 15 other sites around the United States, are conducting the largest effort to date to compare two popular treatments for a form of hearing loss that strikes suddenly and that is potentially curable if treated early.

The study, led by Steven D. Rauch, M.D., compares the effectiveness and possible side effects of corticosteroids taken orally or injected directly into the ear for the treatment of sudden sensorineural hearing loss, or SSHL.

"We want to know if both treatments are equally effective in the treatment of sudden deafness. If they are, then we want to look at the side effects to determine which one is more beneficial for patients," says Dr. Rauch.

Sudden sensorineural hearing loss refers to a rapid loss of hearing, generally in one ear, that can happen all at once or over a period of a few days. The cause is unknown. People may first notice the hearing loss when they wake up in the morning, while using the phone, or after an alarming "pop" occurs. According to Dr. Rauch, SSHL symptoms are similar to common hearing problems that cause ear blockage, such as water in the ear or earwax build-up. Other symptoms may include ringing in the ear (tinnitus), dizziness, or vertigo.

Although most forms of sensorineural hearing loss are irreversible, SSHL is potentially curable if treated early, generally within two weeks of discovering the hearing loss. Steroids are the most common treatment for SSHL, but researchers do not know which method is more effective - taken orally or injected directly into the ear.

To help address this question, researchers are recruiting volunteers, 18 years and older, who have inexplicably experienced hearing loss in one ear. To be eligible, the patient would need to be enrolled in the study within two weeks of experiencing a first-time hearing loss. Enrolled patients will be randomly assigned to receive one of two commonly used treatments: a high dose of oral steroids taken daily for two weeks, then tapering off over several days, or steroid injections in the ear twice each week for two weeks.

In addition to finding the most effective treatment for SSHL, Dr. Rauch and his team hope to raise awareness about SSHL among the emergency medical community, since this condition can frequently be overlooked as a possible diagnosis.

"Patients generally don't worry enough when they experience these symptoms. Even if they do go to see their primary care physician, a hearing test may not be offered to them; they might miss the window of opportunity for treatment," says Dr. Rauch. "Primary care and emergency staff are generally not aware that SSHL is a medical emergency, and that patients need to see an otolaryngologist immediately," he says. An otolaryngologist is a physician who specializes in diseases of the ear, nose, and throat.

If you or someone you know suddenly develops difficulty hearing in one ear, Dr. Rauch recommends a simple test: humming out loud. If the hearing loss is due to earwax or congestion, you will hear your voice louder in the blocked ear. However, if the humming seems louder in your good ear, this could be a sign that you are experiencing SSHL in the affected side and you should contact an otolaryngologist immediately.

The study is being conducted in 16 medical centers in the United States and Canada, including:
* University of California, San Diego
* House Ear Institute, California
* University of Florida
* University of Iowa
* Johns Hopkins University
* Massachusetts Eye and Ear Infirmary
* University of Massachusetts Medical School
* University of Michigan
* Michigan Ear Institute
* Washington University School of Medicine
* New York University School of Medicine
* New York Eye and Ear Infirmary
* The Cleveland Clinic
* University of Texas Southwestern Medical Center
* Baylor College of Medicine
* University of Western Ontario, Canada.