Pharmacological treatment of sensorineural hearing loss

Sudden sensorineural hearing loss is a common and alarming symptom of about 360 million people that suffer from hearing impairment worldwide. The sudden sensorineural hearing loss usually arises unilaterally and it is habitually described as greater than 30dB hearing reduction, attributable to lesions of the cochlea, cranial nerve VIII, brainstem and temporal lobe. There are many factor that promote the onset of this lesions such us infections, circulatory diseases, inner ear neoplasia and neurological disorders. This pathology is characterized by primary symptoms such as the impairment of the comprehension of spoken language and the struggling to listen to music. Subsequently, secondary symptoms arise as well as anxiety, inadequate coping with illness and psychosomatic disturbances that have a negative impact on patients with a significant reduction in the quality of life. Treatment of the sudden sensorineural hearing loss remains one of the most problematic issues for contemporary otorhinolaryngology, because of the wide array of the presumed mechanisms that underpin this disorder. Although the pharmacological treatment remain even now empirical and the management is not standardized in term of medical treatment, duration and route of administration, different agents are used. In the past, pharmacological approaches have included antiviral agents, vitamin, herbal preparations, carbogen inhalations or magnesium, administered on either an inpatient or outpatient procedures. Nowadays, the corticosteroids therapy remains the mainstay strategy, but considering the multifaceted aspects of this disorder, diuretics, anticoagulants, vasodilatators and fibrinolityc agents have also been tried. In this chapter, we will focus mainly on the principal pharmacological approaches of the sudden sensorineural hearing loss that will be described and examined in terms of mechanism of action and effectiveness.