Clinico-audiometric Features and Role of Steroids in Acute Acoustic Trauma

Abstract

Introduction: Acute acoustic trauma implies injury to ear due to explosive blast or impulse noise. It primarily results in sensorineural hearing loss, but also causes tinnitus, earache, ear fullness, unsteadiness or sleep disturbance etc. There is no gold standard treatment protocol which has been found to be convincing. This study was done to compare clinic-audiological recovery in early and late cases following oral steroid therapy.

Materials and Methods: A prospective study was conducted with 40 patients of 18 to 45 years of age suffering from Acute acoustic trauma. Patients reporting within 7 days were considered ‘early cases’ (Group A) and those reporting between 8^th to 28^th day were considered ‘late cases’ (Group B). Following thorough clinical examination, hearing thresholds were recorded before and after treatment with oral prednisolone instituted at 1mg/kg body weight for 7 days tapering over next 7 days. Follow-up audiograms were done on 15th day and 6 months later.

Results: Tinnitus, hearing loss, earache, unsteadiness and tympanic membrane perforation were found in 95%, 90%, 60%, 15% and 30% patients respectively. Majority audiogram showed Type II pattern with high frequency loss. Only 5.26% showed dip at 4kHz. Steroid therapy significantly improved air and bone conduction thresholds in both groups, however, inter-group comparison was not significant. Moreover, early reporters showed significantly better resolution of associated autological features than late reporters.

Conclusion: Study results underline beneficial effect of oral corticosteroids in the treatment of early as well as late presentation of Acute acoustic trauma.