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Rivista di Otorinolaringologia, Chirurgia Maxillo-Facciale,
Chirurgia Plastica Ricostruttiva, Otoneurochirurgia
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2015 Dicembre;65(4):89-95
Treatment of idiopathic sudden hearing loss in subjects with concomitant chronic glaucoma: preliminary experience with sulodexide
Giuliano D. A. 1, Giuliano S. 2, Colombani F. 1
1 Ospedale degli Infermi di Biella, Ponderano, Biella, Italy;
2 Ophthalmology Unit, Azienda Sanitaria Provinciale of Caltanissetta, Caltanissetta, Italy
AIM: The pharmacological treatment of patients with chronic glaucoma and presenting idiopathic sudden hearing loss (ISHL), a frequent association in clinical practice, requires a treatment protocol that will enable rapid recovery of hearing function while protecting the eye against factors that might aggravate the initial clinical situation. Corticosteroids, often used in protocols for ISHL, can cause damages for intraocular pressure. A viable therapeutic alternative could consist of sulodexide, a glycosaminoglycan with antithrombotic and profibrinolytic properties, already used effectively for its vasoactive action on the microcirculation in the vascular, audiovestibular and ophthalmologic diseases. The aim of this study was to perform a preliminary assessment of the effectiveness of an association between sulodexide and mannitol (an osmotic diuretic used in the standard treatment of ISHL) in the treatment of ISHL in patients with chronic glaucoma.
METHODS: Twenty-two patients were observed and divided into two groups: the first group, comprising 10 patients suffering from ISHL and concomitant chronic glaucoma, was treated with sulodexide (IM, 600 LSU/day) and mannitol 18% (IV, 500 cc/day) for 7 days; in the second group, 12 patients suffering only from ISHL, without associated glaucoma, were treated with betamethasone (IV, 4 mg/day) and mannitol 18% (IV, 500 cc/day) for 7 days.
RESULTS: Hearing recovery in the sulodexide/mannitol group was complete in 80% of cases (8/10), marked in 10% (1/10) and slight in the remaining 10% (1/10). In the betamethasone/mannitol group, hearing recovery was complete in 25% of patients (3/12), marked in 50% (6/12) and absent in 25% (3/12). The difference between the two groups was significant (P=0.02).
CONLCUSION: Sulodexide may offer an effective treatment for idiopathic sudden hearing loss, particularly in patients suffering from chronic glaucoma or other concomitant pathologies in which the use of corticosteroids is to be avoided.