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Systemic steroid reduces long-term hearing loss in experimental pneumococcal meningitis

Authors

  • Lise Worsøe MD,

    Corresponding author
    1. Department of Oto-rhino-laryngology, Head and Neck Surgery , Copenhagen University Hospital Gentofte, Hellerup, Denmark
    • Department of Oto-rhino-laryngology, Head and Neck Surgery, Copenhagen University Hospital Gentofte, DK-2900 Hellerup, Denmark
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  • Christian Thomas Brandt MD,

    1. National Center for Antimicrobials and Infection Control, Division of Microbiology Statens Serum Institute,Copenhagen, Denmark
    2. Department of Infectious Diseases , Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
    3. Copenhagen HIV Programme, Faculty of Health Sciences , University of Copenhagen, Copenhagen, Denmark
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  • Søren Peter Lund DVM, PhD,

    1. National Institute of Occupational Health , Copenhagen, Denmark
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  • Christian Østergaard MD, DMsc,

    1. National Center for Antimicrobials and Infection Control, Division of Microbiology Statens Serum Institute,Copenhagen, Denmark
    2. Clinical Microbiological Department , Copenhagen University Hospital Herlev, Herlev, Denmark
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  • Jens Thomsen MD, DMsc,

    1. Department of Oto-rhino-laryngology, Head and Neck Surgery , Copenhagen University Hospital Gentofte, Hellerup, Denmark
    2. Faculty of Health Sciences , University of Copenhagen, Copenhagen, Denmark
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  • Per Cayé-Thomasen MD, DMsc

    1. Department of Oto-rhino-laryngology, Head and Neck Surgery , Copenhagen University Hospital Gentofte, Hellerup, Denmark
    2. Faculty of Health Sciences , University of Copenhagen, Copenhagen, Denmark
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  • This work was supported in part by the following foundations: Desiree og Niels Ydes Fond; Oda Pedersens Fond; Den Laegevidenskabelige Forskningsfond for Storkøbenhavn, Faerøerne og Grønland; Eivind Eckbos dansk-norske Legat; Lily Benthine Lunds Fond; Christian Larsen og Dommer Ellen Larsens Legat; Direktør Jacob Madsen og Hustru Olga Madsens Fond; Fonden til Laegevidenskabens Fremme; and H:S Fondet.

Abstract

Objectives/Hypothesis:

Sensorineural hearing loss is a common complication of pneumococcal meningitis. Treatment with corticosteroids reduces inflammatory response and may thereby reduce hearing loss. However, both experimental studies and clinical trials investigating the effect of corticosteroids on hearing loss have generated conflicting results. The objective of the present study was to determine whether systemic steroid treatment had an effect on hearing loss and cochlear damage in a rat model of pneumococcal meningitis.

Study Design:

Controlled animal study of acute bacterial meningitis.

Methods:

Adult rats were randomly assigned to two experimental treatment groups: a group treated with systemic steroid (n = 13) and a control group treated with saline (n = 13). Treatment was initiated 21 hours after infection and repeated once a day for three days. Hearing loss and cochlear damage were assessed by distortion product otoacoustic emissions (DPOAE), auditory brainstem response (ABR) at 16 kHz, and spiral ganglion neuron density.

Results:

Fifty-six days after infection, steroid treatment significantly reduced hearing loss assessed by DPOAE (P < .05; Mann-Whitney) and showed a trend toward reducing loss of viable neurons in the spiral ganglion (P = .0513; Mann-Whitney). After pooling data from day 22 with data from day 56, we found that systemic steroid treatment significantly reduced loss of spiral ganglion neurons (P = .0098; Mann-Whitney test).

Conclusions:

Systemic steroid treatment reduces long-term hearing loss and loss of spiral ganglion neurons in experimental pneumococcal meningitis in adult rats. The findings support a beneficial role of anti-inflammatory agents in reducing hearing loss and cochlear damage in meningitis. Laryngoscope, 2010

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