Sudden sensorineural hearing loss:

Is antiviral
treatment really necessary ?

Christin Doko Rehi FK UKRIDA

Dian Catur Putri FK UPN
Dmitri M.R FK YARSI
Thiraffi Pastito FK YARSI

Objectives:
It

was aimed to investigate the

necessity of antiviral agents in
the ISSNHL treatment

Methods:
The patients, diagnosed with sudden
hearing loss and admitted in the
first 7 days of hearing loss were
divided into two groups;
Group 1

Group 2

Combined Therapy

Group 1 Therapy +
Famciclovir

Both groups were compared in terms of

levels of recovery

Results:
No

statistically significant
difference was found in the
recovery rates between the two
groups (p = 0.7)

Conclusion:
In

this study, the additional

antiviral treatment was found to
have no effect on the remission
rates in patients with ISSHL
treated with combined therapy.

The

etiopathology of Idiopathic
sudden sensorineural hearing
loss (ISSNHL)
has not been fully clarified

Etiology
Viral infection
Vascular occlusion
perforation of the labyrinthine membranes
Immune-mediated mechanisms
Abnormal stress response in the cochlea

Definition
Sudden

hearing loss is defined as

development of more than 30 dB
of sensorineural hearing loss at 3
sequential frequencies in less
than 3 days.

There

are variety of treatment

protocol have been empirically
applied in ISSNHL, but without
revealing the cause clearly.
Hence all the modalities need
explanation.

Modalities
Vasodilators
Steroids
Diuretics
Anticoagulants
Plasma Expander
CO2

49% - 89%

Backgrounds
In

recent studies, viral agents

were considered responsible in a
significant number of patients
with ISSNHL, and antiviral-agent
acyclovir has been proposed as
an effective treatment option

?
1.)

Many clinicians have

started to add antiviral therapy to
their treatment by considering
viral etiology, albeit improvable.
2.)
The efficacy of antiviral
therapy could not be
demonstrated clearly, and, there
is a debate on how and by which
ways the viruses cause ISSNHL as
well

The

aim of this study is to

determine whether the patients
with ISSNHL benefit from early
treatment with famciclovir

Materials and methods

41

patients were included in the

study, according to the inclusion
criteria
the patients that were administered
with a combined treatment and the
patients administered with
famciclovir in addition to the
combined therapy were divided into
groups according to their hearing
loss treatments

Group 1

Group 2

Steroid

the combined treatment in

the Group 1

Rheomacrodex
(500 cc, as to continue for
8 hours, for 5 days)

+
the additional famciclovir
treatment.
Famciclovir 3 250 mg
orally, for 7 days

Piracetam
(3 2 g ampule for 5 days)
Lansoprol capsule
(1 1 for stomach
protection)

Tests
Before

and after the treatment, the

patients were evaluated by
audiometric examinations on the 7th
day, 10th day, 1st month and 6th
month.
The pure tone audiometry,
Speech reception thresholds (SRT),
Discrimination,
Stapes reflex
Tympanometric examinations

In

order to ensure
standardization of the groups,
the patients were proportionally
divided into the groups in terms
of the factors (degree of loss, the
shape of the audiogram,
presence of vertigo and/or
tinnitus, age) that may affect
prognosis

The

patients with more than 15

dB gain were considered to have
benefited from the treatment

Statistical analysis
Fisher's

exact test was used in 2

2 tables
Nonparametric Mann-Whitney U
test
SPSS for Windows 10.0
p < 0.05 was considered as
statistically significant

Results

Discussion
There

is no any exact method of treatment that

presents successful results has been found yet.

there

is not much objective evidence that supports the

viral etiology

guideline was published by the American Academy of

Otolaryngology for sudden hearing loss. The panel
made a recommendation against clinicians routinely
prescribing antivirals to patients with ISSNHL

Conclusion
The

etiology of ISSNHL is not

clarified yet
The additional antiviral treatment
was found to have no effect on
remission rates
Without a history of viral
infection supposedly the patients
are not given antiviral treatment

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