Adverse Effects of Steroid Therapy in Sudden Sensorineural Hearing Loss:
A Scoping Review
Abstract
Objective Sudden sensorineural hearing loss (SSNHL) is an otologic
emergency and treated with steroid therapy. Despite adverse events (AEs)
associated with long term steroid use being well evidenced, there is
sparsity of literature regarding the AEs of short-course prescriptions
in the SSNHL cohort, which limits the quality of patient counselling and
informed consent. Method A literature search was performed on the
Medline and Embase databases for studies assessing AEs in adults with
SSNHL managed with oral (OST), intratympanic (ITS) and intravenous
steroid therapy (IVS). Two authors screened titles, abstracts, and
full-text articles, with conflicts resolved by a third reviewer.
Forty-three papers were included. Results In systemic steroid therapies,
hyperglycaemia and hypertension are reported in up to 29.8% and 37.9%
of patients respectively. Patients with medication-dependent diabetes
and hypertension are at higher risk. Gastric and mood disturbances
affected up to 27.9% and 44.6% of patients respectively. ITS carried
risks of otalgia (up to 54.3%), dizziness (up to 27.1%), perforations
(up to 11.5%), and otitis media (up to 4.7%). Conclusion Comprehensive
counselling is key in obtaining informed consent, especially in cohorts
with diabetes mellitus (DM) and hypertension where monitoring of glucose
and blood pressure is recommended. Gastroprotection should be
considered. Future focus is required to study short-term steroid AEs and
raise awareness amongst prescribing clinicians and patients.