- Otol Neurotol. 2003 May;24(3):465-8.
The efficacy of corticosteroids in restoring hearing in patients undergoing conservative management of acoustic neuromas.'
Aronzon A, Ruckenstein MJ, Bigelow DC.
of Otolaryngology and Head and Neck Surgery, University of Pennsylvania
Medical Center, Philadelphia, Pennsylvania 19104, USA.
To evaluate the role of corticosteroids in restoring hearing in
patients undergoing conservative management of acoustic neuromas.
DESIGN: Prospective cohort.
SETTING:Tertiary referral center.
Seven patients with acute hearing loss secondary to an acoustic
INTERVENTION: Oral prednisone (1 mg/kg for 1 to 2 weeks)
within a week of onset of hearing loss.
MAIN OUTCOME MEASURES:
Audiometric assessment at the time of presentation and after
RESULTS: All seven patients had pure tone
reception threshold improvements ranging from 10 to 50 dB in at least
two frequencies or more. Speech discrimination thresholds improved
after therapy in all seven patients, with gains of 4 to 38% points.
CONCLUSIONS: Patients with acoustic neuromas who are being treated with
a "watchful waiting" approach should receive corticosteroid treatment
at the first signs of hearing deterioration. An evaluation to rule out
a retrocochlear lesion is mandated in patients with sudden hearing
loss, regardless of whether the hearing loss responds to corticosteroid
treatment. Older data documenting the efficacy of corticosteroids in
the treatment of sudden hearing loss may need to be reevaluated, given
that many of these studies were conducted before MRI was available.