Side effects of cortisone therapy for sudden hearing loss
Unfortunately, the side effects of glucocorticoids, like the effects, are very broad. Since glucocorticoids are taken up (more frequently) via tablets or infusions, they have a systemic effect. This means that they are absorbed into the bloodstream by the mucous membrane of the digestive tract and thus act throughout the body.
In an infusion, the cortisone is directly in the bloodstream. This has the positive effect that the ear is also reached and the inflammation or swelling is combated there. On the other hand, this also means that many undesirable side effects can occur throughout the body.
On the one hand, blood sugar can rise due to the formation of new sugar. This can be particularly problematic for diabetics. An increase in the fat level in the blood can also be observed.
In addition, swelling can occur due to water accumulation in the tissue (so-called oedema). Prolonged intake of cortisone can lead to a so-called “full moon face”, which manifests itself in a rounded face shape with bloated cheeks. In addition to the metabolic processes, the skin and muscles are also affected.
The musculature is broken down by the altered protein metabolism and the skin becomes thinner. The circulation and psyche can also be influenced. Finally, the reduction in immune activity is accompanied by a higher susceptibility to infections.
The desired effect can also have its dark sides. For this reason, it is also recommended to wait for a possible improvement before starting cortisone therapy and to take glucocorticoids only if there is no improvement. However, systemic side effects are not to be feared in the case of a cortisone injection which only works locally in the middle ear.
Interactions of cortisone
In addition to the numerous side effects, cortisone therapy also has various interactions. For example, cortisone should not be used in the treatment of acute viral or bacterial infections. In cases of severe diabetes mellitus or high blood pressure, glucocorticoids should only be taken with special caution. Cortisone therapy should also be avoided in connection with vaccinations. In any case, current illnesses and the intake of other medications in connection with cortisone therapy should be discussed with the treating physician!
Further accompanying therapy for sudden hearing loss
In addition to the cortisone therapy, there are various accompanying therapy approaches which can be tried out. One example is the oxygen overpressure therapy. Here the patient is in a hyperbaric chamber and breathes pure oxygen.
The theory behind this is that the increased oxygen concentration in the blood improves the supply of oxygen to the hair cells of the inner ear. However, studies have shown that the effectiveness is lower than therapy with glucocorticoids. Alternatively, there are treatment methods that focus on the blood supply to the ear.
A new and until now rarely used method is “blood purification”. Here, a dialysis procedure is used to remove the blood from the vein through a small tube, clean it in a machine and then put it back into the vein. The cleaning process mainly involves the removal of fats (LDL cholesterol, lipoprotein a) and coagulation factors (e.g. fibrinogen). The cleansing is intended to improve blood flow and ensure better blood circulation in the inner ear. However, this form of therapy is not covered by health insurance and is particularly recommended in cases of increased fibrinogen levels.
