Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-26T15:20:40.906Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of oral steroid regimens for acute acoustic trauma caused by gunshot noise exposure

Published online by Cambridge University Press:  11 June 2019

N Choi ,
J S Kim  and
Y-S Chang
N Choi
Affiliation:
Department of Otorhinolaryngology, Republic of Korea Armed Forces Capital Hospital, Bundang, Republic of Korea
J S Kim
Affiliation:
28th Regiment, 9th Division, Republic of Korea Armed Forces, Goyang, Republic of Korea
Y-S Chang*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan-si, Republic of Korea
*
Author for correspondence: Dr Young-Soo Chang, Department of Otorhinolaryngology – Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, Republic of Korea15355 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There are no definite guidelines regarding the most adequate steroid regimens for acute acoustic trauma.

Objective

To elucidate the dose-dependent differing benefits of oral steroids on hearing improvement following acute acoustic trauma.

Methods

Twenty-nine patients treated with oral steroids following a diagnosis of unilateral acute acoustic trauma were retrospectively reviewed. Patients were sorted into two groups with an oral steroid regimen. Group 1 received a 14-day course of treatment: 60 mg prednisolone daily for 10 days, tapering off over days 11–14. Group 2 received prednisolone for a total of 10 days: 60 mg for 5 days, tapering down each day for the remainder. Multivariable linear regression analysis was performed to evaluate the factors associated with the hearing gain.

Results

In the multivariable regression (R2 = 0.51, p < 0.001), patients in group 1 showed more significant improvement in the degree of hearing gain compared to group 2 (p = 0.03).

Conclusion

After comparing the differing benefits of oral steroids on hearing improvement by dosage, we recommend a high dose of prednisolone (60 mg per day) for 10 days, tapering over the remaining 4 days, for better hearing recovery following acute acoustic trauma.

Keywords

Hearing Loss, Noise-InducedAcoustic TraumaSteroidsOral Drug AdministrationPrednisolone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 7 , July 2019 , pp. 566 - 570
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr Y-S Chang takes responsibility for the integrity of the content of the paper

References

1Roberto, M, Zito, F. Scar formation following impulse noise-induced mechanical damage to the organ of Corti. J Laryngol Otol 1988;102:2–9Google Scholar
2Yong, JS, Wang, DY. Impact of noise on hearing in the military. Mil Med Res 2015;2:6Google Scholar
3Lin, CY, Wu, JL, Shih, TS, Tsai, PJ, Sun, YM, Ma, MC et al. N-Acetyl-cysteine against noise-induced temporary threshold shift in male workers. Hear Res 2010;269:42–7Google Scholar
4Wells, TS, Seelig, AD, Ryan, MA, Jones, JM, Hooper, TI, Jacobson, IG et al. Hearing loss associated with US military combat deployment. Noise Health 2015;17:34–42Google Scholar
5Flottorp, G. Treatment of noise induced hearing loss. Scand Audiol Suppl 1991;34:123–30Google Scholar
6Remenschneider, AK, Lookabaugh, S, Aliphas, A, Brodsky, JR, Devaiah, AK, Dagher, W et al. Otologic outcomes after blast injury: the Boston Marathon experience. Otol Neurotol 2014;35:1825–34Google Scholar
7Bonfort, G, Billot, D, Trendel, D, Salf, E, Lindas, P, Barberot, JP. Acute acoustic trauma, a retrospective analysis about 225 military cases [in French]. Rev Laryngol Otol Rhinol (Bord) 2014;135:25–31Google Scholar
8Yehudai, N, Fink, N, Shpriz, M, Marom, T. Acute acoustic trauma among soldiers during an intense combat. J Am Acad Audiol 2017;28:436–43Google Scholar
9Chang, YS, Bang, KH, Jeong, B, Lee, GG. Effects of early intratympanic steroid injection in patients with acoustic trauma caused by gunshot noise. Acta Otolaryngol 2017;137:716–19Google Scholar
10Harada, H, Shiraishi, K, Kato, T. Prognosis of acute acoustic trauma: a retrospective study using multiple logistic regression analysis. Auris Nasus Larynx 2001;28:117–20Google Scholar
11Psillas, G, Pavlidis, P, Karvelis, I, Kekes, G, Vital, V, Constantinidis, J. Potential efficacy of early treatment of acute acoustic trauma with steroids and piracetam after gunshot noise. Eur Arch Otorhinolaryngol 2008;265:1465–9Google Scholar
12Chang, Y-S, Bang, K, Choi, N, Kim, JS, Lee, G-G. Factors associated with the benefits of concurrent administration of intratympanic steroid injection with oral steroids in patients with acute acoustic trauma. Otol Neurotol 2018;39:565–70Google Scholar
13Zhou, Y, Zheng, G, Zheng, H, Zhou, R, Zhu, X, Zhang, Q. Primary observation of early transtympanic steroid injection in patients with delayed treatment of noise-induced hearing loss. Audiol Neurootol 2013;18:89–94Google Scholar
14Maassen, M, Babisch, W, Bachmann, KD, Ising, H, Lehnert, G, Plath, P et al. Ear damage caused by leisure noise. Noise Health 2001;4:1–16Google Scholar