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.
Check http://www.meei.harvard.edu/research/trialstudies/ssnhl.php for
more information about this study. A description of the protocol is
available at http://www.clinicaltrials.gov/ct/show/NCT00097448?order=16.
Read NIDCD's online fact sheet on sudden sensorineural hearing loss at
http://www.nidcd.nih.gov/health/hearing/sudden.asp.
