Živić Ljubica, Živić Danijela, Djonović Nela
Srp Arh Celok Lek. 2012 Mar-Apr;140(3-4):153-8. doi: 10.2298/sarh1204153z.
Sudden hearing loss is a clinical entity of ambiguously defined aetiology manifested by hearing loss of more than 30 dB on three contiguous frequencies occurring within 72 hours. The lack of standard therapy protocol led to the use of variety of different therapies, thus making difficult objective quantification of their effect.
The aim of the study was to present our experience in the treatment of sudden hearing loss with administration of vasoactive and corticosteroid therapy.
Our research included 59 hospitally treated patients with a sudden hearing loss. During the period 1995-2004, 37 patients were treated using vasoactive agents (xanthinol nicotinate and pentoxifylline), and from 2004-2009, 22 patients were treated using parenteral corticosteroids (dexamethasone). All patients had unilateral sensorineural hearing loss of different level at frequencies from 500-4000 Hz, while other diagnostic procedures (laboratory tests, internist and neurology examinations, X-ray) were within normal limits. Evaluation of therapy effect was done by follow-up of hearing threshold changes and subjective complaints.
The results showed that full recovery was achieved in patients with a mild and not fully severe hearing loss, with the majority of those (73%) under corticosteroid treatment. In these patients recovery was also achieved more rapidly. A partial recovery of hearing was detected in patients with hearing loss of more than 80 dB, and mostly in patients treated with corticosteroids.
Although statistical evaluation does not indicate significant differences between the application of vasoactive drugs or corticosteroids, clinical findings support advantages of corticosteroid therapy. Treatment of hearing loss, although controversial, requires change of some up-to-now used agents. Advantages should go in favour of contricosteroids.
突发性听力损失是一种病因定义不明确的临床病症，表现为在72小时内三个连续频率的听力损失超过30分贝。由于缺乏标准治疗方案，导致使用了多种不同疗法，因此难以对其效果进行客观量化。
本研究的目的是介绍我们使用血管活性药物和皮质类固醇疗法治疗突发性听力损失的经验。
我们的研究纳入了59例住院治疗的突发性听力损失患者。在1995年至2004年期间，37例患者使用血管活性药物（烟酸占替诺和己酮可可碱）进行治疗，而在2004年至2009年期间，22例患者使用肠外皮质类固醇（地塞米松）进行治疗。所有患者在500 - 4000赫兹频率下均有不同程度的单侧感音神经性听力损失，而其他诊断程序（实验室检查、内科和神经科检查、X线检查）均在正常范围内。通过随访听力阈值变化和主观症状来评估治疗效果。
结果显示，轻度和不完全重度听力损失的患者实现了完全康复，其中大多数（73%）接受皮质类固醇治疗。这些患者的康复也更快。听力损失超过80分贝的患者出现了部分听力恢复，且大多是接受皮质类固醇治疗的患者。
尽管统计学评估未显示血管活性药物或皮质类固醇应用之间存在显著差异，但临床结果支持皮质类固醇疗法的优势。听力损失的治疗虽然存在争议，但需要改变一些目前使用的药物。优势应倾向于皮质类固醇。
