Westerlaken Boris Olivier, Stokroos Robert Jan, Dhooge Inge Johanna Maria, Wit Hero Piet, Albers Frans Willem Jan
Department of Otorhinolaryngology, University Hospital Groningen, Groningen, The Netherlands.
Ann Otol Rhinol Laryngol. 2003 Nov;112(11):993-1000. doi: 10.1177/000348940311201113.
A subclinical viral labyrinthitis has been postulated in the literature to elicit idiopathic sudden sensorineural hearing loss (ISSHL). An etiologic role for the herpes family is assumed. Corticosteroids possess a limited beneficial effect on hearing recovery in ISSHL. In this study, we evaluated the therapeutic value of the antiherpetic drug acyclovir (Zovirax) on hearing recovery in 91 patients with ISSHL who received prednisolone in a prospective, randomized, double-blind, placebo-controlled, multicenter trial. The audiometric parameters included pure tone and speech audiometry. Subjective parameters studied included hearing recovery, a pressure sensation in the affected ear, vertigo, and tinnitus. A 1-year follow-up was obtained. Hearing recovery for the whole group averaged about 35 dB and was independent of the severity of the initial hearing loss or vestibular involvement. Speech audiometry improved from 49% to 75%. After 12 months, pressure sensation and vertigo decreased to 15.6% (acyclovir) and 10.3% (placebo) and 12.5% (acyclovir) and 10.7% (placebo), respectively. Tinnitus decreased slightly, to 46.9% (acyclovir) and 55.2% (placebo), in the same period (p > .05 for all parameters). We conclude that no beneficial effect from combining acyclovir with prednisolone can be established in patients with ISSHL.
文献中曾推测亚临床病毒性迷路炎可引发特发性突发性感音神经性听力损失（ISSHL）。假定疱疹病毒家族具有病因学作用。皮质类固醇对ISSHL患者的听力恢复有益作用有限。在本研究中，我们在一项前瞻性、随机、双盲、安慰剂对照、多中心试验中，评估了抗疱疹药物阿昔洛韦（无环鸟苷）对91例接受泼尼松龙治疗的ISSHL患者听力恢复的治疗价值。听力测定参数包括纯音听力测定和言语听力测定。所研究的主观参数包括听力恢复、患耳的压迫感、眩晕和耳鸣。进行了为期1年的随访。整个组的听力恢复平均约为35分贝，且与初始听力损失或前庭受累的严重程度无关。言语听力测定从49%提高到75%。12个月后，压迫感和眩晕分别降至15.6%（阿昔洛韦组）和10.3%（安慰剂组）以及12.5%（阿昔洛韦组）和10.7%（安慰剂组）。同期耳鸣略有下降，分别降至46.9%（阿昔洛韦组）和55.2%（安慰剂组）（所有参数p>0.05）。我们得出结论，对于ISSHL患者，无法确定阿昔洛韦与泼尼松龙联合使用有有益效果。
