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Susan

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 #1 
Hello Dr. Nagler,

I wonder if you could comment on the use of short term (4mg dosepak) prednisone for recent onset of tinnitus brought on by exposure to loud noise. Has it shown to be effective in reducing tinnitus and were the effects long lasting? I have read a few things online (nih studies?) where it was helpful in small numbers of people early in the course of their symptoms. I have also read where it is included in ototoxic drug lists and actually increased tinnitus in small numbers of people. Also, the side effects of insomnia and anxiety are concerning, but I assume are short term. I guess my question is risk vs. benefit.

Thank you.
Susan
Dr. Nagler

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 #2 
Excellent question, Susan.

ENTs frequently prescribe a short course of prednisolone to individuals who present with sudden sensorineural hearing loss. The data are not overly compelling, but the risks of a short course of steroids is really negligible - especially when compared with the benefits to be derived in terms of potential reversal of the hearing loss. The same thinking goes into the tendency for some to prescribe a short course of steroids for noise-induced tinnitus of very recent onset. But as weak as the data are for sudden sensorineural hearing loss in that regard, they are even weaker for tinnitus.

Prednisolone is not ototoxic. Any exacerbation of tinnitus that might occur during the type of short course you describe is reversible.

Hope this helps.

Dr. Stephen Nagler

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