AZATHIOPRINE WITH CORTISONE IN TREATMENT OF HEARING-LOSS IN ONLY HEARING EAR

A sudden or progressive hearing loss in the only hearing ear is an oto logic emergency, in which therapeutic possibilities are limited. We de scribe results of immunosuppressive therapy in 10 patients with one de afened ear either due to cochlear hydrops or Meniere's disease, who de veloped progressive or fluctuant hearing loss in the only hearing ear. The perilymphatic fistula was excluded with tympanoscopy. Azathioprin e (25 mg t.i.d.) with prednisone (initial dose 20-40 mg with daily dos e of 5-15 mg/day) was used. The hearing of 6 subjects responded to tre atment. The initial pure tone audiogram (PTA) at speech frequencies of the ''only hearing ear'' was 57.3 dB HL with speech discrimination sc ore (SDS) of 85%. The hearing improvement occurred successively within days or weeks. The average improvement of PTA was 22.4 dB HL after th e mean treatment period of 5 weeks. In contralateral ear (the average PTA and SDS were 72.5 dB HL. and 28%, respectively) the mean improveme nt in PTA was insignificant (4.4 dB). In 5 patients with vertigo it wa s improved in 3 cases. Cortisone alone or with combination of cyclopho sphamide or ciclosporine was not effective in our hands.