Progression of tinnitus in the context of treatment of sudden hearing loss with glucocorticoids – Results from the HODOKORT study

Introduction Tinnitus is a common symptom of sudden sensorineural hearing loss. Within the randomized study HODOKORT for investigation of the efficacy of systemic, high-dose glucocorticoid therapy we evaluated the incidence and development of tinnitus.

Materials & Methods In 40 study centres, the patients were randomly separated in three groups: intervention group 1 (n=101) with high-dose intravenous prednisolone, intervention group 2 with high-dose oral dexamethasone (n=105) and control group with oral prednisolone (n=102). We evaluated the change of loudness and annoyance of tinnitus via visual analog scale at visit day 30 and visit day 180.

Results In 80,2% of all patients, tinnitus appeared as part of a sudden sensorineural hearing loss. 78 patients (77,2%) in the intervention group 1 (intravenous prednisolone) indicated a new or reinforced tinnitus. 89 patients (84,8%) in the intervention group 2 (oral dexamethasone) confirmed the symptom of tinnitus. Among the control group patients, 80 patients (78,4%) stated the presence of tinnitus. Overall groups, the symptoms improved over time. The the regression of tinnitus was less in the group of intravenous (high dose-)prednisolone.

Discussion Tinnitus as a common symptom of sudden sensorineural hearing loss leads to annoyance of patients. In our patient group tinnitus appeared in approximately 80%. In the course of time, the distress of tinnitus was in regression, but our observation of a lower improvement in the group with high-dose glucocorticoid therapy must be considered an as an argument against high-dose glucocorticoid therapy of sudden hearing loss.

Funding information BMBF

Publication History

Article published online:
19 April 2024