Estudio comparativo del efecto sobre la recuperación auditiva de la prednisona oral iniciada dentro de las primeras 24 horas frente a su inicio posterior a las 24 horas en pacientes con hipoacusia neurosensorial súbita idiopática.

Abstract

Introduction: Although there is no universally accepted treatment for the management of idiopathic sudden sensorineural hearing loss (HSSI), the use of oral corticosteroid is considered the first choice. The diagnosis and timely treatment of HSSI is decisive for auditory recovery. Objective: To compare the use of oral prednisone and its effect on auditory recovery in patients with HSSI treated within the first 24 hours with those treated after 24 hours. Materials and methods: A comparative, retrospective and longitudinal study consisting of 97 patients with HSSI diagnosed and treated by the otorhinolaryngology department of Dr. Teodoro Maldonado Carbo Hospital during January 2010 and March 2018, who were treated with the oral prednisone 1mg / kg / day = 4x4 4x3 4x2 4x1 scheme. Audiometric and logoaudiometric tests were carried out before and after treatment. Results: 48% of the patients obtained a complete or partial recovery with the use of oral prednisone at any time of its administration, with a mean posttreatment PTA of 17,24 dB + -25.37. There is a significant difference in the recovery of post-treatment PTA in patients treated in the first 24 hours with an average PTA of 32.65 decibels + - 18.23 dB (p-value = 0.000), an average range of absolute PTA of 68.00 dB and PTA relative of 67.59% (p value = 0.000) compared to those who started the treatment after 24 hours. Conclusions: The use of oral prednisone as a treatment in the HSSI administered in the first 24 hours offers superior and more effective hearing recovery than oral prednisone administered after 24 hours. The effect of oral prednisone decreases considerably if it is administered after 7 days of presenting the event.