| Effect of Adding Metformin to Standard High Dose Systemic Steroid Therapy in Non-Diabetic Patients With Sudden Sensorineural Hearing Loss |
Jae Won Jang
, Hyeon Seok Goo
, Joong Keun Kwon
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| Department of Otolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea |
| 비당뇨 돌발성감각신경성난청 환자에서 표준 고용량 전신 스테로이드 요법에 메트포르민을 병용 투여했을 때의 효과 |
장재원
, 구현석
, 권중근
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| 울산대학교 의과대학 울산대학교병원 이비인후과학교실 |
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Received: 23 March 2026; Revised: May 11, 2026 Accepted: 19 May 2026. Published online: 22 July 2026. |
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| ABSTRACT |
Background and Objectives Sudden sensorineural hearing loss (SSNHL) is commonly treated with high-dose systemic corticosteroids, yet recovery remains incomplete in a substantial proportion of patients. Metformin has pleiotropic anti-inflammatory, immunomodulatory, and vascular-protective effects and may mitigate steroid-induced dysglycemia. This study evaluated whether adding metformin to the standard high-dose glucocorticoid therapy improves hearing outcomes in nondiabetic SSNHL.
Subjects and Method This retrospective observational cohort study included patients treated for idiopathic SSNHL at a single tertiary center (July 2020-July 2025). All patients received oral methylprednisolone of 48 mg/day for 10 days followed by taper; non-responders received intratympanic dexamethasone (up to four injections). The metformin group additionally received metformin of 500 mg/day for 4 weeks. Variable ratio propensity score matching (caliper 0.2) was controlled for age, vertigo, onset-to-treatment interval, and baseline pure-tone average (PTA). Outcomes were changes in the PTA and word recognition score (WRS), and American Academy of Otolaryngology-Head and Neck Surgery Foundation recovery categories. Groupby-time interaction was tested using a linear mixed model.
Results After matching, 68 patients were analyzed (control n=44; metformin n=24). Both groups showed significant improvement in PTA and WRS; however, between-group differences were not significant (PTA interaction p=0.779; WRS interaction p=0.965). Complete recovery occurred in 43.2% of controls and 33.3% of metformin patients.
Conclusion In nondiabetic SSNHL, short-term low-dose metformin added to the standard high-dose steroid therapy did not provide additional hearing benefit. |
| Keywords:
Glucocorticoidsㆍ Hearing testsㆍ Metforminㆍ Propensity scoreㆍ Sudden hearing loss |
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