Omega-3 Adjunctive Therapy in Idiopathic SSNHL: A Randomised, Triple-Blind, Placebo-Controlled Trial

Document Type : Original

Authors

1 Otorhinolaryngologist-Head and Neck Surgeon, Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Radiology, Arak University of Medical Sciences, Arak, Iran.

Abstract

Introduction:
Idiopathic Sudden Sensorineural Hearing Loss as a subset of sensorineural hearing loss will be confirmed by a progressive hearing loss of at least 30 dB at three contiguous frequencies over 72 hours or less. A sudden or abrupt hearing loss correlates with the time course, and a vascular event is presumptive aetiology. There is an inverse association between Omega-3 consumption and hearing loss. This study aimed to evaluate the efficacy of Omega-3 adjunctive therapy in Idiopathic Sudden Sensorineural Hearing Loss by audiometric assessments.
Materials and Methods:
In this randomised, triple-blind, placebo-controlled trial, all participants aged 18-70 with a history of sudden deafness (within 12 hours and ≤ 30 days) were eligible for enrollment. They were included if audiology diagnostic tests confirmed the SSNHL. Ultimately, they were randomised to the Omega-3 group and the placebo group.
Results:
Thirty-three patients were randomly allocated to the Omega-3 group and thirty-two to the placebo group. Vertigo (32.3% of all patients) and underlying conditions had significant relationships with complete response (C.R.)-final hearing level ≤of 25 dB in pure-tone average (P < 0.05). There was no significant difference between both groups before and after treatment. Although it was not statistically significant, patients in the Omega-3 group had faster recovery than placebo.
Conclusions:
Omega-3 adjunctive therapy did not have a therapeutic effect on SSNHL patients. Moreover, C.R. happened in half the patients. Vertigo and underlying conditions considerably worsen the recovery from SSNHL.

Keywords

Main Subjects


  1. H. Alexander Arts MEA. Sensorineural Hearing Loss in Adults. In: Flint PW, editor. Cummings Otolaryngology-Head and Neck Surgery. 3. 7th ed. Philadelphia: Elsevier; 2020. p. 2311.
  2. (NIDCD) NIoDaOCD. Sudden Deafness: U.S. Department of Health & Human Services; 2018 [Available from: https://www. nidcd.nih.gov/ health/ sudden-deafness.
  3. Mattox DE, Lyles CA. Idiopathic sudden sensorineural hearing loss. Am J Otol. 1989;10(3):242-7.
  4. Neeraj N Mathur MMC, Michele M Carr, Francisco Talavera, Peter S Roland, Arlen D Meyers, Sudden Hearing Loss2019. Available from: https:// emedicine. medscape.com/article/856313-overview#a5.
  5. Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, et al. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev [Internet]. 2012 2012/05//; (5):[CD002137 p.]. Available from: http:// europepmc. org/abstract/MED/22592684

https: // doi.org/10.1002/14651858.CD002137.pub3

https://europepmc.org/articles/PMC6486029https://europepmc.org/articles/PMC6486029?pdf=render.

  1. Gopinath B, Flood VM, Rochtchina E, McMahon CM, Mitchell P. Consumption of omega-3 fatty acids and fish and risk of age-related hearing loss. The American Journal of Clinical Nutrition. 2010;92(2):416-21.
  2. Schulz KF, Altman DG, Moher D, the CG. CONSORT 2010 Statement: updated guidelines for parallel reporting group randomised trials. BMC Medicine. 2010;8(1):18.
  3. Cheng YF, Chu YC, Tu TY, Shiao AS, Wu SL, Liao WH. Modified Siegel's sudden sensorineural hearing loss criteria: Reporting recovery outcomes with matched pretreatment hearing grades. Journal of the Chinese Medical Association: JCMA. 2018; 81(11):1008-12.
  4. Gurgel RK, Jackler RK, Dobie RA, Popelka GR. A New Standardized Format for Reporting Hearing Outcome in Clinical Trials. 2012;147(5):803-7.
  5. Brownson RJ, Zollinger WK, Madeira T, Fell D. Sudden sensorineural hearing loss following cervical spine manipulation. 1986;96(2):166-70.
  6. Ciccone MM, Scicchitano P, Gesualdo M, Cortese F, Zito A, Manca F, et al. Idiopathic sudden sensorineural hearing loss and ménière syndrome: The role of cerebral venous drainage. 2018; 43(1): 230-9.
  7. Chang C-F, Kuo Y-L, Chen S-P, Wang M-C, Liao W-H, Tu T-Y, et al. Relationship between idiopathic sudden sensorineural hearing loss and subsequent stroke. 2013;123(4):1011-5.
  8. Choung Y-H, Park K, Shin YR, Cho MJ. Intratympanic Dexamethasone Injection for Refractory Sudden Sensorineural Hearing Loss. 2006; 116(5):747-52.
  9. Jung DJ, Park JH, Jang JH, Lee K-Y. The efficacy of combination therapy for idiopathic sudden sensorineural hearing loss. 2016; 126(8): 1871-6.
  10. Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.
  11. Siegert E, Paul F, Rothe M, Weylandt KH. The effect of omega-3 fatty acids on central nervous system remyelination in fat-1 mice. BMC Neurosci. 2017;18(1):19.
  12. Balk EM, Lichtenstein AH, Chung M, Kupelnick B, Chew P, Lau J. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review.Atherosclerosis.2006;189(1):19-30.
  13. Musa-Veloso K, Binns MA, Kocenas AC, Poon T, Elliot JA, Rice H, et al. Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid dose-dependently reduce fasting serum triglycerides. 2010;68(3):155-67.
  14. Martin JM, Stapleton RD. Omega-3 fatty acids in critical illness. 2010;68(9):531-41.
  15. Xie Y, Orabi NA, Zwolan TA, Basura GJ. Outcomes of unilateral idiopathic sudden sensorineural hearing loss: Two decades of experience. 2019;4(6):693-702.
  16. Shimanuki MN, Shinden S, Oishi N, Suzuki N, Iwabu K, Kitama T, et al. Early hearing improvement predicts the prognosis of idiopathic sudden sensorineural hearing loss. European Archives of Oto-Rhino-Laryngology. 2021.
  17. Kuhn M, Heman-Ackah SE, Shaikh JA, Roehm PC. Sudden Sensorineural Hearing Loss: A Review of Diagnosis, Treatment, and Prognosis. 2011; 15(3): 91-105.
  18. Michos ED, McEvoy JW, Blumenthal RS. Lipid Management for the Prevention of Atherosclerotic Cardiovascular Disease. 2019;381(16):1557-67.
  19. Aung T, Halsey J, Kromhout D, Gerstein HC, Marchioli R, Tavazzi L, et al. Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals. JAMA Cardiology. 2018; 3(3): 225-33.
  20. Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, et al. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. The Cochrane database of systematic reviews. 2018;11(11):Cd003177.
  21. Partearroyo T, Vallecillo N, Pajares MA, Varela-Moreiras G, Varela-Nieto I. Cochlear Homocysteine Metabolism at the Crossroad of Nutrition and Sensorineural Hearing Loss. 2017;10(107).
  22. Lasisi AO, Fehintola FA, Yusuf OB. Age-related hearing loss, vitamin B12, and folate in the elderly. Otolaryngology-Head and Neck Surgery. 2010; 143(6): 826-30.