Background: Cause and underlying pathogenic mechanisms of idiopathic sudden hearing loss (ISHL) are not fully understood, resulting in the widespread use of different polypragmatic treatment approaches, which have not been finally validated in randomized controlled trials. Quality of life (QoL) can provide helpful additional information when selecting the most appropriate therapy within current options.
Methods: In a prospective, multicenter, randomized, controlled clinical study, Rheopheresis-a method of therapeutic apheresis-was compared with a standard therapy consisting of either intravenous corticosteroids or hemodilution using pure-tone and speech audiometry. Quality of life as secondary outcome parameter was documented using the German Medical Outcome Short Form (36) Health Survey questionnaire.
Results: Two hundred forty patients were included in this trial. All three treatment options proved to be of equal efficacy regarding absolute and relative hearing gain or speech discrimination. Quality of life measured in Medical Outcome Short Form (36) Health Survey scores was less than the level of the normal German population at baseline for all groups, and mentally, ISHL patients felt more impaired than patients who have chronic hearing impairment. Rheopheresis treatment led to a higher QoL at the time of the follow-up visit compared with the drug-based therapies and compared with a large representative sample of the German general population.
Discussion: Treatments leading to accelerated recovery in combination with a minimal number of therapeutic interventions, for example, Rheopheresis, seemed to have a considerable effect on QoL. Because there is a dearth of evidence of efficacy for any treatment option in ISHL, QoL can provide additional information when choosing the most appropriate treatment option.