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. 2025 Apr 15:102:100794.
doi: 10.1016/j.curtheres.2025.100794. eCollection 2025.

Efficacy and Side Effect of Different Doses of Glucocorticoids on Sudden Deafness

Ya He  1 , Liang'e Zhi  2 , Yajin Feng  1 , Shiyuan Li  3 , Qian Liu  4 , Zhendong Jiang  1 , Cheng Zhong  1
Affiliations

Efficacy and Side Effect of Different Doses of Glucocorticoids on Sudden Deafness

Ya He et al. Curr Ther Res Clin Exp. .

Abstract

Background: Sudden deafness (SD) presents as rapid-onset sensorineural hearing loss within 72 hours, with unknown etiology. Current guidelines recommend systemic corticosteroids as first-line therapy, though high-dose regimens may increase risks of hypertension and hyperglycemia. No consensus exists on optimal SD treatment protocols.

Objective: To compare the treatment efficacy and side effects of different doses of glucocorticoids in patients with sudden deafness.

Methods: A total of 248 patients (from July 2020 to May 2022) with sudden deafness were divided into 3 groups based on their initial dexamethasone dosages: group A (adequate dose, 10 mg/d), group B (high dose, 15 mg/d), and group C (high dose, 20 mg/d). For treatment efficacy, the mean hearing threshold elevation was subsequently evaluated. For side effects, blood glucose and blood pressure were monitored in 14 patients with sudden deafness accompanied by diabetes and 20 patients with concomitant primary hypertension.

Results: There was no significant difference in the efficacy of various initial corticosteroid doses among different subgroups (all P > 0.05). Higher initial doses were associated with increased risk of rapid glucose in patients with diabetes, whereas no significant difference was observed in blood pressure fluctuation among the 3 groups.

Conclusions: The treatment efficacy of the 3 different corticosteroid doses in sudden deafness treatment was comparable; yet, an increased risk of rapid blood glucose increase was accompanied by the elevated dose of dexamethasone in patients with diabetes. Therefore, an adequate glucocorticoid (dexamethasone, 10 mg/d) could be the optimal regimen of patients with sudden deafness and diabetes.

Keywords: Administration dosage; Corticosteroid; Sudden deafness.

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Conflict of interest statement

We, the authors, declare that there are no conflicts of interest associated with this research. This study was conducted independently, and no financial or personal relationships with other organizations or individuals could have influenced the design, conduct, or reporting of the study.

Figures

Fig 1
Fig. 1
The elevated pure-tone threshold among the 3 groups with different initial corticosteroid dosages.
Fig 2
Fig. 2
Differences in daily blood glucose concentration means between 2 groups and volumetric distribution chart of daily blood glucose CV. (A) Mean interstitial glucose concentration for patients with diabetes treated by group A (7 cases) and group B (7 cases). Values represent mean (SD). The X-axis signifies time of a day. (B) Box and whisker plots of daily mean glucose concentration for patients in group A and group B. The box represents the median and interquartile range. The upper whisker extends upward to 75th centile + 1.5 × interquartile range or the maximum value, whichever is lower. The lower whisker extends downwards to the 25th centile − 1.5 × the interquartile range or the minimum value, whichever is greater. The small dots in the graph represent the outliers for the group. (C) The volumetric distribution chart of daily blood glucose CV for patients with diabetes in group A and group B. The yellow vertical line in the figure corresponds to the abscissa CV value of 0.36, representing the CV standard line in the graph. The ordinate corresponding to the intersection of the yellow line with the 2 curves represents the proportion of patients in both groups with CV < 0.36 (CV compliance rate: group A, 68.00%; group B, 68.57%). *P < 0.05.
Fig 3
Fig. 3
Mean blood pressure differences at various time intervals and boxplots of blood pressure values among patients under different corticosteroid treatment regimens. (A and B) The mean systolic blood pressure (SBP) or diastolic blood pressure (DBP) values at different time intervals (morning/noon/evening) for primary hypertensive patients classified into group A (11 cases), group B (7 cases), and group C (2 cases). X-axis represents the time of day when blood pressure measurements were taken. (C and D) The SBP or DBP boxplots for patients classified into group A (11 cases), group B (7 cases), and group C (2 cases) in the morning. The small dots in the graph represent outlier points within each group. (E and F) The SBP or DBP boxplots for patients with primary hypertension classified into group A (11 cases), group B (7 cases), and group C (2 cases) at noon. The small dots in the graph represent outlier points within each group. (G and H) The SBP or DBP boxplot for patients with primary hypertension classified into group A (11 cases), group B (7 cases), and group C (2 cases) in the evening.
Fig 4
Fig. 4
Treatment outcomes for (A) vertigos and (B) tinnitus.
See this image and copyright information in PMC

References

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