Otolaryngology Department, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
Otolaryngol Head Neck Surg. 2013 Nov;149(5):753-8. doi: 10.1177/0194599813500754. Epub 2013 Aug 19.
The purpose of this study was to compare the efficacy of systemic steroid alone and combined with intratympanic methylprednisolone in the treatment of patients with idiopathic sudden sensorineural hearing loss.
Prospective, randomized controlled trial. Settings Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
Seventy-nine patients who met the inclusion criteria for idiopathic sudden sensorineural hearing loss were included in this study. Patients were randomly divided into 2 groups according to treatment: group A received combination therapy (intratympanic methylprednisolone + oral steroid) and group B received oral steroid alone. Of the 79 patients included, 6 patients missed the 1-month follow-up visit. Overall, 73 patients (37 combination group, 36 oral steroid group) who completed the 1-month follow-up and study intervention were included in the per-protocol analysis. Both the relationship between certain prognostic factors and the clinical outcome after treatment were analyzed.
Combination therapy showed significant hearing improvement and speech discrimination scores compared with the use of systemic steroids alone (P < .05). In hearing outcomes in patients with severe hearing loss, combination therapy had statistically significant hearing improvement compared with oral steroid alone (P < .05).
We recommend that combination therapy can be considered as initial treatment especially for patients with severe hearing loss.
本研究旨在比较全身类固醇单独治疗与鼓室内甲泼尼龙联合治疗特发性突发性聋患者的疗效。
前瞻性、随机对照试验。地点土耳其伊兹密尔 Katip Celebi 大学 Ataturk 培训和研究医院。
符合特发性突发性聋纳入标准的 79 例患者纳入本研究。患者根据治疗方法随机分为 2 组：A 组接受联合治疗（鼓室内甲泼尼龙+口服类固醇），B 组接受单纯口服类固醇治疗。79 例患者中，6 例患者在 1 个月随访时失访。共有 73 例患者（联合组 37 例，口服类固醇组 36 例）完成了 1 个月的随访和研究干预，并纳入了意向性治疗分析。分析了某些预后因素与治疗后临床结果之间的关系。
与单独使用全身类固醇相比，联合治疗在听力改善和言语辨别评分方面具有显著优势（P<.05）。对于重度听力损失患者的听力结果，联合治疗在听力改善方面与单纯口服类固醇相比具有统计学意义（P<.05）。
我们建议联合治疗可作为初始治疗方法，特别是对重度听力损失患者。
