Comparison of oral steroid regimens for acute acoustic trauma caused by gunshot noise exposure.

ABSTRACT

BACKGROUND: There are no definite guidelines regarding the most adequate steroid regimens for acute acoustic trauma. OBJECTIVE: To elucidate the dose-dependent differing benefits of oral steroids on hearing improvement following acute acoustic trauma. METHODS: Twenty-nine patients treated with oral steroids following a diagnosis of unilateral acute acoustic trauma were retrospectively reviewed. Patients were sorted into two groups with an oral steroid regimen. Group 1 received a 14-day course of treatment 60 mg prednisolone daily for 10 days, tapering off over days 11-14. Group 2 received prednisolone for a total of 10 days 60 mg for 5 days, tapering down each day for the remainder. Multivariable linear regression analysis was performed to evaluate the factors associated with the hearing gain. RESULTS: In the multivariable regression (R2 = 0.51, p < 0.001), patients in group 1 showed more significant improvement in the degree of hearing gain compared to group 2 (p = 0.03). CONCLUSION: After comparing the differing benefits of oral steroids on hearing improvement by dosage, we recommend a high dose of prednisolone (60 mg per day) for 10 days, tapering over the remaining 4 days, for better hearing recovery following acute acoustic trauma.