Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss

Milan Kostal, Jakub Drsata, Milan Bláha, Miriam Lánská, Viktor Chrobok, Milan Kostal, Jakub Drsata, Milan Bláha, Miriam Lánská, Viktor Chrobok

Abstract

Backround: Only few therapeutic options exist for patients with refractory sudden idiopathic sensorineural hearing loss (SISHL). Little is known about the efficacy of second-line therapies. Rheopheresis seems to be an effective therapeutic possibility.

Methods: Between 2012 and 2015, 106 patients with SISHL were enrolled in the study, of whom 52 were refractory to initial treatment. As salvage therapy, these patients were offered either 3 sessions of rheopheresis (33 pts) or intratympanic steroid treatment through MicroWick application (19 pts). Pure tone audiometry was performed at diagnosis, at the 1st month and the 1st year during the follow-up.

Results: Patients in the rheopheretic arm had higher hearing loss than in the MicroWick arm (81% vs. 52%, p = 0.04). In spite of this, there was a significant improvement for patients in the rheopheretic arm (27% of hearing loss reduction, p < 0.001) after the 1st month and this remained unchanged during the 1st year, while no improvement was seen in the MicroWick arm (0% of hearing loss reduction, p = 0.424). We found no predictive factor for steroid-failure in first-line therapy. Older age (p = 0.003), presence of vertigo (p = 0.006) and more profound initial hearing loss (p < 0.001) were identified as negative prognostic markers.

Conclusion: Rheopheresis can be used as a potentially effective and safe salvage therapy for patients with cortico-refractory SISHL.

Keywords: MicroWick; Rheopheresis; Sudden idiopathic hearing loss.

Conflict of interest statement

Ethics approval and consent to participate

All patients signed inform consent before entering into the study. No study drug or procedure was applied. This is an observational study.

Consent for publication

We confirm that this manuscript has not been published elsewhere and is not under consideration by another journal. All authors agreed with publication in Journal of Otolaryngology-Head & Neck Surgery.

Competing interests

ALL authors have no conflicts of interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Study design
Fig. 2
Fig. 2
Results of standard therapy only
Fig. 3
Fig. 3
Results of rheopheretic arm
Fig. 4
Fig. 4
Results of MicroWick arm

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