Alpha lipoic acid is a cofactor of mitochondrial respiratory enzymes, scavenging free radicals, blocking metal ions, and exhibiting the effect of recycling antioxidants. As a result of these antioxidant effects, in several animal and clinical trials, the association between anti-cancer toxic hearing loss and noise-induced hearing loss was reported. In our previous studies, protective effects on cisplatin-induced ototoxicity were also confirmed through animal experiments.
In this study, steroid monotherapy (systemic steroid injection and steroid tympanic injection) and combination therapy to add alpha lipoic acid, which has recently been introduced as a treatment method for ototoxic and noise-induced hearing loss, in the treatment of patients with sudden and noise-induced hearing loss.we aim to analyze the treatment effect on the pure tone hearing threshold and speech hearing test results over time. We intend to proceed with the study on the assumption that there will be an additional effect of hearing improvement by using alphalipoic acid, an antioxidant that has a large preventive effect in ototoxicity and noise-induced hearing loss.
Among patients treated for sudden and noise-induced hearing loss, the group received thioctic acid once a day (10 days) while performing systemic steroid + intratympanic steroid injection (3 times), and only systemic steroid + intratympanic steroid injection (3 times) It was planned to be divided into the groups administered and observed for a year as a case-control study.

Cohort/Group Label

Control group

Cohort/Group Description

Control group(standard treatment) :Intravenous injection of steroid (10 mg of dexamethasone once a day for 5 days-> 5 mg of dexamethasone once a day for 5 days) + Steroid intratympanic injection (0.4 to 0.5 cc in 1 ample of dexamethasone) once every 2 days (3 times in total during the hospital stay)

Cohort/Group Label

Experimental group (addition of alpha lipoic acid)

Cohort/Group Description

Experimental group (addition of alpha lipoic acid) : Control group protocol (standard treatment) + 600mg of alpha lipoic acid (intravenous injection once a day for 10 days during hospitalization)

Not collect nor Archive

Adults (20 years of age or older) who are diagnosed with sudden hearing loss and noise-induced hearing loss and treat in our hospitalization

Prospective, open, block randomization, probability sample

Gender

Age

Description

sudden hearing loss 
A.	Hearing loss [30 dB in 3 consecutive frequency within 72 h]
B.	Sudden hearing loss must be unilateral.

Noise-induced hearing loss- trensient threshold shift)
A.	A temporary shift in the auditory threshold suddenly after exposure to a high level of noise

Common inclusion criteria
A.	No initial treatment before;
B.	Must apply within 2 weeks after onset;
C.	Age more than 20 years

A.	Presence of acute or chronic otitis media;
B.	Had previous otologic surgery;
C.	Trauma;
D.	Presence of a neoplasm;
E.	Recent application of radiotherapy and/or chemotherapy;
F.	Recent use of ototoxic drugs;
G.	Syphilis;
H.	Retro-cochlear lesion.
I.	Age  <  20 years
J.	Pregnant, lactating, possibly pregnant women
K.	Cisplatin user
L.	Severe liver disease or kidney disease
M.	Uncontrolled DM
N.	Active infectious disease ( e.g. herpes zoster, chicken pox, tuberculosis)
O.	Cataract, glaucoma, severe osteoporosis
P.	Seizure, myasthenia gravis
Q.	Hypothyroidism, congestive heart disease
R.	Recent bowl surgery
S.	Ischemic heart disease, embolism. 
T.	Patients who have hypersensitivity reaction of alpha-lipoic acid or steroid

To compare the effect of treatment with steroid therapy and alpha-lipoic acid in combination with sudden hearing loss or noise-induced hearing loss over time and the results of pure tone hearing threshold (change in pure tone hearing threshold by frequency)

Before treatment, 10 days later, 20 days later, 1 month, 3 months, 1 year

Changes in speech discernment

Before treatment, 10 days later, 20 days later, 1 month, 3 months, 1 year