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Evidence summaries

Antivirals for Idiopathic Sudden Sensorineural Hearing Loss

Antiviral drugs are probably not effective in the treatment of idiopathic sudden sensorineural hearing loss. Level of evidence: "C"

Summary

A Cochrane review [Abstract] 1 included 4 studies with a total of 257 subjects with idiopathic sudden sensorineural hearing loss (ISSHL). Two trials (n=113) compared the addition of iv. acyclovir to prednisolone. Neither demonstrated any hearing improvement with ISSHL. Another trial (n=84) did not show any significant difference between groups with the addition of valacyclovir to prednisolone (compared to steroid plus placebo) with respect to change in pure-tone audiogram. Comparing the addition of iv. acyclovir to hydrocortisone with hydrocortisone alone, the fourth trial (n=60) did not show any statistically significant difference between groups. No trial documented any serious adverse effects related to the use of antiviral treatment. Even though no meta-analysis was possible, evidence from 4 RCTs has demonstrated no significant advantage in the use of antivirals in the treatment of ISSHL.

Comment: The quality of the evidence is downgraded by inconsistency (heterogeneity in patients, interventions and outcomes) and imprecise results (small sample size in each trial).

Clinical comments

Note

Date of latest search:

    References

    • Awad Z, Huins C, Pothier DD. Antivirals for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 2012;8:CD006987. [PubMed]

Primary/Secondary Keywords