Pezzoli M, Magnano M, Maffi L, Pezzoli L, Marcato P, Orione M, Cupi D, Bongioannini G
ENT Department, Hospital Mauriziano "Umberto I", Corso Re Umberto 109, 10128, Turin, Italy,
Eur Arch Otorhinolaryngol. 2015 Jul;272(7):1659-66. doi: 10.1007/s00405-014-2948-z. Epub 2014 Oct 16.
The most commonly used treatment for sensorineural sudden hearing loss (SSHL) in clinical practice is the administration of steroids; however, a favorable result is not always obtained. We studied 58 patients who failed to recover after primary treatment with IV steroids, 44 of these met our inclusion criteria (mean age 50.7, 27 males, range 30-74). We treated 23 patients (mean age 47.3, 16 males, age range 22-74) with hyperbaric oxygen therapy (HBO) (2.5 ATA for 60 min for 15 treatments), while 21 (mean age 54.5, 11 males, age range 22-71) patients refused to be treated and served as a non-randomized control group. Patients treated with HBO had a mean improvement of 15.6 dB (SD ± 15.3), with 1 of them completely healed, 5 with a good recovery, 10 with a fair recovery and 7 unchanged. Patients who were not treated had a spontaneous mean improvement of 5.0 dB (SD ± 11.4) with 3 patients with a good recovery, 1 patient with a fair recovery and 17 patients unchanged. Mean improvement was significantly better in patients treated with HBO compared to controls (p = 0.0133). Patients with worst hearing had the greater degree of improvement whether or not they were treated in the first 10 days after the onset of the hearing loss or between 11 and 30 days. In conclusion, hyperbaric oxygen therapy can lead to significant improvement of pure tone hearing thresholds in patients with SSHL who failed primary corticosteroid treatment and are within 4 weeks of the onset of deafness.
临床实践中,感音神经性突发听力损失(SSHL)最常用的治疗方法是使用类固醇;然而,并非总能获得理想的效果。我们研究了58例初次接受静脉注射类固醇治疗后未恢复的患者,其中44例符合我们的纳入标准(平均年龄50.7岁,男性27例,年龄范围30 - 74岁)。我们对23例患者(平均年龄47.3岁,男性16例,年龄范围22 - 74岁)进行了高压氧治疗(HBO)(2.5ATA,60分钟,共15次治疗),而21例患者(平均年龄54.5岁,男性11例,年龄范围22 - 71岁)拒绝接受治疗,作为非随机对照组。接受HBO治疗的患者平均听力改善了15.6dB(标准差±15.3),其中1例完全治愈,5例恢复良好,10例恢复一般,7例无变化。未接受治疗的患者平均自发改善了5.0dB(标准差±11.4),其中3例恢复良好,1例恢复一般,17例无变化。与对照组相比,接受HBO治疗的患者平均改善情况明显更好(p = 0.0133)。听力损失最严重的患者,无论在听力损失发作后的前10天内还是在11至30天内接受治疗,改善程度都更大。总之,高压氧治疗可使初次皮质类固醇治疗失败且在耳聋发作4周内的SSHL患者的纯音听力阈值得到显著改善。