Third-generation bisphosphonates for treatment of sensorineural hearing loss in otosclerosis.

Abstract

OBJECTIVE:

To evaluate hearing outcomes in patients treated with third generation bisphosphonates for otosclerosis-related sensorineural hearing loss (SNHL).

HYPOTHESIS:

Otosclerosis is a disease of abnormal bone remodeling in the otic capsule. In recent years, third generation bisphosphonates, with more powerful anti-resorptive properties and increased bone affinity, have demonstrated effectiveness in the treatment of osteoporosis and other metabolic bone diseases. We hypothesized that newer generation bisphosphonates, such as risedronate and zoledronate, would be effective in slowing the progression of SNHL in patients with otosclerosis.

STUDY DESIGN:

Retrospective review.

SETTING:

Tertiary referral center, ambulatory care.

INTERVENTIONS:

Risedronate or zoledronate administration.

MAIN OUTCOME MEASURES:

Bone conduction pure tone threshold averages (PTAs) and word recognition (WR) scores were examined for each ear before and after bisphosphonate treatment. Criteria for significant change were defined as greater than 10 decibels in PTA or between 4% and 18% in WR based on binomial variance.

RESULTS:

All 10 patients had audiometric progression of SNHL in the pretreatment monitoring interval and 12 ears met criteria for significant progression. All 10 patients (19 ears) showed at least no significant progression of SNHL (i.e., stabilization) at an average follow-up of 13 months. Two patients (3 ears) showed improvement by defined audiometric criteria. There were no major complications.

CONCLUSION:

Treatment with zoledronate or risedronate stabilized progressive SNHL related to otosclerosis in this small group of patients. Further evaluation of third-generation bisphosphonate treatments is warranted.

• Authors: Alicia M Quesnel, Margaret Seton, Saumil N Merchant, Christopher Halpin, Michael J McKenna
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 33 Issue 8 Pg. 1308-14 (Oct 2012) ISSN: 1537-4505 [Electronic] United States
• PMID: 22935809 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Bone Density Conservation Agents
• Diphosphonates
• Imidazoles
• Zoledronic Acid
• Risedronic Acid
• Etidronic Acid

Topics

• Adult
• Aged
• Audiometry, Pure-Tone
• Auditory Threshold (physiology)
• Bone Conduction (physiology)
• Bone Density Conservation Agents (therapeutic use)
• Diphosphonates (therapeutic use)
• Etidronic Acid (analogs & derivatives, therapeutic use)
• Female
• Hearing Loss, Sensorineural (drug therapy, etiology)
• Humans
• Imidazoles (therapeutic use)
• Male
• Middle Aged
• Otosclerosis (complications, drug therapy)
• Retrospective Studies
• Risedronic Acid
• Speech Perception
• Tomography, X-Ray Computed
• Treatment Outcome
• Zoledronic Acid