Penido Norma de Oliveira, Ramos Hugo Valter Lisboa, Barros Flávia Alencar, Cruz Oswaldo Laércio Mendonça, Toledo Ronaldo Nunes
Federal University of Sao Paulo, Escola Paulista de Medicina.
Braz J Otorhinolaryngol. 2005 Sep-Oct;71(5):633-8. doi: 10.1016/s1808-8694(15)31268-4. Epub 2006 Mar 31.
Out of the many forms of therapy for sudden deafness, some require hospitalization and present significant risks.
This prospective study analyzes etiology and evolution in cases of sudden deafness (SD) where outpatient oral treatment was used.
Clinical with transversal cohort.
Forty cases of sudden hearing loss were followed for at least one year. All were submitted to initial clinical evaluation, auditory tests, routine blood analysis, and magnetic resonance imaging. All received initial treatment with pentoxifylline and prednisone.
45% (n=18) presented normal auditory thresholds, 40% (n=16) showed some improvement in hearing, 15% (n=6) maintained initial hearing level. Nine cases (22.5%) presented clinical conditions possibly implicated in hearing loss (viral infection, immunomediated hearing loss, vascular disorders, and so on); three (7.5%) had cerebellopontine tumors. Evolution of hearing in these 12 cases with presumed etiology presented no differences from hearing in the 28 cases without any known etiological factor. Clinical treatment within the first seven days was the only statistically significantly different condition in patients who improved hearing.
An objective search for etiological bases should be conducted in any case of acute sensorineural hearing loss. The presence of cerebellopontine tumors in 7.5% of cases of SD, among other treated causes, justifies a thorough clinical investigation in these patients. Overall good evolution of hearing was observed in 67.5% of cases of SD, regardless of its etiology. Therapy within the first seven days of SD was significantly related to better outcomes in hearing.
在突发性耳聋的多种治疗方法中，有些需要住院治疗且存在重大风险。
本前瞻性研究分析了采用门诊口服治疗的突发性耳聋（SD）病例的病因及病情发展。
横向队列临床研究。
对40例突发性听力损失患者进行了至少一年的随访。所有患者均接受了初始临床评估、听力测试、血常规分析和磁共振成像检查。所有患者均接受了己酮可可碱和泼尼松的初始治疗。
45%（n = 18）的患者听觉阈值恢复正常，40%（n = 16）的患者听力有所改善，15%（n = 6）的患者维持初始听力水平。9例（22.5%）患者的临床状况可能与听力损失有关（病毒感染、免疫介导性听力损失、血管疾病等）；3例（7.5%）患有桥小脑角肿瘤。这12例推测有病因的患者的听力变化与28例无任何已知病因的患者的听力变化无差异。在听力改善的患者中，仅第1至7天内的临床治疗情况在统计学上有显著差异。
对于任何急性感音神经性听力损失病例，均应客观地寻找病因依据。在突发性耳聋病例中，7.5%存在桥小脑角肿瘤，以及其他已治疗的病因，证明对这些患者进行全面的临床检查是合理的。无论病因如何，在67.5%的突发性耳聋病例中观察到听力总体改善良好。突发性耳聋第1至7天内的治疗与听力更好的预后显著相关。
