Filipo Roberto, Attanasio Giuseppe, Viccaro Marika, Russo Francesca Y, Mancini Patrizia, Rocco Monica, Pietropaoli Paolo, Covelli Edoardo
Department of Sensory Organs, Sapienza University of Rome, Italy.
Acta Otolaryngol. 2012 May;132(5):475-81. doi: 10.3109/00016489.2011.647360. Epub 2012 Jan 31.
The excellent tolerability of intratympanic (IT) steroid offers the possibility to use a high dose, which would appear to be more effective than intravenous (IV) steroid treatment, when both are associated with hyperbaric oxygen (HBO) therapy.
The purpose of the study was to assess for the first time the efficacy of the association of IT steroid and HBO therapy in patients presenting idiopathic sudden sensorineural hearing loss (ISSNHL), comparing this protocol with another consisting of IV steroid administration and HBO therapy.
A total of 48 patients presenting ISSNHL were recruited. Patients were divided into two categories: the severe ISSNHL group with a pure-tone average (PTA) between 70 and 90 dB, and the profound ISSNHL group with a PTA >90 dB. The first protocol consisted of 10 days of HBO therapy together with IV methylprednisolone 1 mg/kg body weight for 7 days; the second protocol consisted of HBO therapy for 10 days, associated with an IT injection of prednisolone at a dose of 62.5 mg/ml, once a day for 3 consecutive days, performed 2 h before the HBO therapy.
The overall success rate was superior in the group submitted to IT steroid and HBO therapy. Nevertheless, these clinical results were not statistically significant.
鼓室内(IT)注射类固醇具有良好的耐受性,这使得使用高剂量成为可能。当鼓室内注射类固醇和静脉注射(IV)类固醇治疗均与高压氧(HBO)治疗联用时,前者似乎比后者更有效。
本研究旨在首次评估鼓室内注射类固醇与HBO治疗联合应用于特发性突发性感音神经性听力损失(ISSNHL)患者的疗效,并将该方案与另一种由静脉注射类固醇和HBO治疗组成的方案进行比较。
共招募了48例ISSNHL患者。患者分为两类:纯音平均听阈(PTA)在70至90dB之间的重度ISSNHL组,以及PTA>90dB的极重度ISSNHL组。第一个方案包括10天的HBO治疗以及静脉注射甲泼尼龙1mg/kg体重,持续7天;第二个方案包括10天的HBO治疗,在HBO治疗前2小时,连续3天每天一次鼓室内注射剂量为62.