gms | German Medical Science

Background and objective: For patients suffering from recurring sudden hearing loss (SHL) refractory to standard infusion therapy, new therapeutic options have to be established. LDL-fibrinogen apheresis, covering Rheopheresis and HELP-apheresis for the indication of SHL, has been shown to be equally effective compared to standard therapy in two large controlled randomised clinical trials, each with more than 200 patients [Ref. 1], [Ref. 2], [Ref. 3].

Patients and methods: In this study, patients who suffered from recurring and progressive SHL refractory to anti-inflammatory-antiphlogistic infusion therapy were retrospectively analysed. After unsuccessful infusion therapy following the last onset of SHL patients were treated with Rheopheresis twice. Hearing gain and recovery of speech discrimination were analysed.

Results: 25 patients with in mean 2,1 ± 0,4 events of SHL within 30,0 ± 21,6 months were examined. Patients’ mean hearing loss before first onset of SHL was 34 dB and was reduced by infusion therapy to 20 dB. At second onset of SHL, hearing loss remained almost unchanged after infusion therapy. Patients showed an improvement of 20 dB in mean after two consecutive Rheopheresis treatments. 40% of patients showed complete, further 28% partial remission of SHL.

Conclusion: Rheopheresis can significantly improve restoration of hearing of recurring SHL patients refractory to standard infusion therapy. Fibrinogen-LDL-apheresis in this trial has been shown to be an effective treatment option according to German SHL guidelines that should be considered for patients refractory to the first line standard treatment. The patient must pay the costs for the treatment or apply for individual reimbursement.