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Evidence summaries

Vasodilators and Vasoactive Substances for Idiopathic Sudden Sensorineural Hearing Loss

Vasodilators might possibly have limited effect in the treatment of ISSHL, but the evidence is insufficient. Level of evidence: "D"

A Cochrane review 1 included three trials with 189 participants. One study showed a significant difference in hearing recovery in the vasodilator group (carbogen combined with a course of several other drugs) compared to the control group (a course of several other drugs alone) (76.9% in treatment group and 50% in control group, P < 0.05). Another study only showed a significant improvement (44% versus 13%) in higher frequencies in the vasodilator group (prostaglandin E1 + steroid) compared with the control group (placebo and steroid), no difference having been shown in overall hearing gain. In the third study the vasodilator group (naftidrofuryl and low-molecular weight dextran) showed an 70% improvement only in lower frequencies over the control group (placebo and low-molecular weight dextran, 40%).

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and blinding) and by imprecise results (few patients and wide confidence intervals, differences in interventions).

    References

    • Agarwal L, Pothier DD. Vasodilators and vasoactive substances for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 2009;(4):CD003422[PubMed].

Primary/Secondary Keywords