Naiboğllu Bariş, Külekçi Semra, Sürmeli Mehmet, Verim Ayşegül, Kalaycik Ertugay Çiğdem, İhvan Önder, Şeneldir Lütfü, Zer Toros Sema
Department of Otolaryngology, Haydarpaşa Numune Training Hospital, 34668 Üsküdar, İstanbul, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2015;25(2):77-81. doi: 10.5606/kbbihtisas.2015.65768.
This study aims to investigate whether addition of intratympanic steroid (ITS) to systemic steroid and hyperbaric oxygen (HBO) is effective in the treatment of sudden hearing loss (SHL).
Between January 2008 and October 2011, 58 patients diagnosed with SHL were enrolled in the study. Twenty patients (11 males, 9 females; mean age 45.3±21 years; range 24 to 66 years) who received systemic steroid and HBO composed group 1, while 38 patients (19 males, 19 females; mean age 41.6±16 years; range 25 to 61 years) who received ITS in addition to systemic steroid and HBO composed group 2.
Post-treatment hearing improvement was statistically significant in both groups in terms of the mean pure tone according to the Siegel's criteria (p<0.05). Treatment was successful at 55% of patients in group 1 and 63% in group 2. Despite increased success rate with the addition of ITS, it did not indicate statistical significance (p>0.05). However, there was a strong statistically significant difference in terms of profound hearing loss over 90 dB (p<0.05). None of six patients (0%) with profound hearing loss in group 1 benefited treatment, while addition of ITS to the treatment yielded success in six of 12 patients with profound hearing loss (50%) in group 2 (p<0.05).
Addition of ITS to systemic steroid and HBO treatment may yield better results in patients with SHL. However, ITS injection seems beneficial for patients with profound SHL.
本研究旨在调查在全身用类固醇和高压氧(HBO)治疗基础上加用鼓室内类固醇(ITS)治疗突发性听力损失(SHL)是否有效。
2008年1月至2011年10月期间,58例被诊断为SHL的患者纳入本研究。20例患者(11例男性,9例女性;平均年龄45.3±21岁;范围24至66岁)接受全身用类固醇和HBO治疗,组成第1组,而38例患者(19例男性,19例女性;平均年龄41.6±16岁;范围25至61岁)在接受全身用类固醇和HBO治疗基础上加用ITS,组成第2组。
根据西格尔标准,两组治疗后平均纯音听力改善在统计学上均有显著意义(p<0.05)。第1组55%的患者治疗成功,第2组为63%。尽管加用ITS后成功率有所提高,但差异无统计学意义(p>0.05)。然而,在90 dB以上的重度听力损失方面存在统计学上的显著差异(p<0.05)。第1组6例重度听力损失患者(0%)均未从治疗中获益,而第2组12例重度听力损失患者中有6例(50%)在治疗中加用ITS后取得成功(p<0.05)。
在全身用类固醇和HBO治疗基础上加用ITS可能对SHL患者产生更好的效果。然而,ITS注射似乎对重度SHL患者有益。