Is Corticosteroid Safe Enough for the Treatment of Sudden Hearing Loss and Bell’s Palsy in Diabetic and Hypertensive Patients?

Özet

Objective: To investigate the side effects of systemic corticosteroid (CS) treatment in the idiopathic sudden sensorineural hearing loss (ISSHL) and Bell’s palsy patients. Material and Meth-ods: The patients were retrospectively evaluated for the major side ef-fects of systemic CS. The patients with systemic diseases (hypertension and diabetes mellitus) were further investigated with respect to alter-ations on antidiabetic or antihypertensive drug regimens. The catego-rization was performed according to the dosage alterations of antidiabetic or antihypertensive drugs and the patients were divided into 3 groups: Group 1 (stable group), Group 2 (acute dysregulated group) and Group 3 (chronic dysregulated group). Results: Among the 276 patients, there was only one major complication which was a femur avascular necrosis during a mean follow up 4,5 months. In the diabetic group, the acute and chronic drug alteration was statistically signifi-cantly higher with respect to hypertensive group (p<0.001). HbA1c≥8% (64 mmol/mol) caused a significant increase in Group 3 ratio (p<0.05). Conclusion: The risk of major side effect of the systemic CS was ex-tremely low (<1%). Corticosteroids in patients with hypertension did not alter the antihypertensive doses however, diabetic patients needed drug alteration. HbA1c level<8% (64 mmol/mol) can be used as a safety criterion for starting systemic CS therapy in the diabetic patients with ISSHL and Bell’s palsy.