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口服类固醇治疗突发性感音神经性听力损失:一项十年回顾性分析。

Oral steroid treatment of sudden sensorineural hearing loss: a ten year retrospective analysis.

作者信息

Chen Chu-Yao, Halpin Chris, Rauch Steven D

机构信息

Department of Otolaryngology, Chang Gung Memorial Hospital, Keelung, Taiwan.

出版信息

Otol Neurotol. 2003 Sep;24(5):728-33. doi: 10.1097/00129492-200309000-00006.

Abstract

OBJECTIVE

To describe ten years of experience with Sudden Sensorineural Hearing Loss and compare the outcomes with and without treatment with oral corticosteroids.

STUDY DESIGN

Retrospective review of medical records.

SETTING

Large specialty hospital, Department of Otolaryngology.

PATIENTS

Patients presenting with sudden onset (72 hours) unilateral sensorineural hearing loss, with no evidence of Ménière's Disease, acoustic injury, retrocochlear disease, and other specifiable disorders.

INTERVENTIONS

The majority of patients received a standard course of oral corticosteroids (Prednisone 60 mg and taper). A smaller group declined treatment.

MAIN OUTCOME MEASURES

Recovery of hearing sensitivity was measured using standard audiometry and reported as change in Pure Tone Average. Word recognition scores were also analyzed.

RESULTS

When severe-to-profound cases are analyzed, a significant improvement (p <.01) in Pure Tone Average is seen in cases treated with steroids versus those untreated. When milder cases are included, a statistical floor effect prevents differentiation of these groups. Word recognition scores were significantly improved (p <.05) in the treated group.

CONCLUSIONS

Application of steroid medication significantly improves the recovery outcomes in cases of Severe Sudden Sensorineural Hearing Loss.

摘要

目的

描述十年突发性感音神经性听力损失的经验,并比较口服皮质类固醇治疗与未治疗的结果。

研究设计

对病历进行回顾性分析。

研究地点

大型专科医院耳鼻喉科。

患者

突发(72小时内)单侧感音神经性听力损失患者,无梅尼埃病、声学损伤、蜗后疾病及其他可明确疾病的证据。

干预措施

大多数患者接受标准疗程的口服皮质类固醇治疗(泼尼松60mg并逐渐减量)。一小部分患者拒绝治疗。

主要观察指标

使用标准听力测定法测量听力敏感度恢复情况,并报告为纯音平均听阈的变化。还分析了单词识别分数。

结果

分析重度至极重度病例时,与未治疗的病例相比,接受类固醇治疗的病例纯音平均听阈有显著改善(p<.01)。纳入较轻病例时,统计学上的下限效应使这些组无法区分。治疗组的单词识别分数有显著提高(p<.05)。

结论

在重度突发性感音神经性听力损失病例中,应用类固醇药物可显著改善恢复结果。

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