Jung Da Jung, Park Ji Hye, Jang Jeong Hun, Lee Kyu-Yup
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
Laryngoscope. 2016 Aug;126(8):1871-6. doi: 10.1002/lary.25751. Epub 2016 Mar 12.
OBJECTIVES/HYPOTHESIS: The aim of this study was to compare the hearing results of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) who initially were treated with either a combination therapy of systemic steroids (SS) and intratympanic steroid injection (IT-S) or SS only.
The study followed a retrospective case-control design. One-hundred five patients who were diagnosed with ISSNHL and required treatment via admission were enrolled in this study. The control group (n = 53) was treated with SS, and the study group (n = 52) received SS as well as IT-S. We divided the patients according to pretreatment hearing levels. The outcome measured was improvement after the treatment audiology data at pretreatment were compared with those at day 10 and > 90 days after the treatment. Outcome data were analyzed using the t test, Pearson's χ(2) test, Fisher's exact test, and multivariate analyses of covariance with adjustment for pretreatment hearing levels.
After more than 90 days, the average pure tone audiometry (PTA) in the control and study groups were 54.8 ± 31.4 dB and 43 ± 31.2 dB, respectively (P = 0.013). Hearing recovery rate was 57.7% in the control group and 69.8% in the study group. The hearing gain of the study group was higher than that of the control group at high frequencies within the 10 days of the treatment period. Analysis between subgroups, divided according to the severity of pretreatment hearing level, showed that the recovery rate was higher at all frequencies in the study group than in the control group in patients with mild to moderate hearing loss (pretreatment PTA < 70 dB). However, in patients with severe to profound hearing loss (pretreatment PTA ≥ 70 dB), the hearing outcomes of the study and control groups were not significantly different, except at a low frequency.
The results of this study suggest that the treatment of ISSNHL with combination therapy results in higher hearing recovery rates when compared to treatment with SS alone, even in patients with severe hearing loss.
3b. Laryngoscope, 126:1871-1876, 2016.
目的/假设：本研究旨在比较特发性突发性感音神经性听力损失（ISSNHL）患者的听力结果，这些患者最初接受全身类固醇（SS）和鼓室内类固醇注射（IT-S）联合治疗或仅接受SS治疗。
本研究采用回顾性病例对照设计。105例被诊断为ISSNHL并需要入院治疗的患者纳入本研究。对照组（n = 53）接受SS治疗，研究组（n = 52）接受SS以及IT-S治疗。我们根据治疗前听力水平对患者进行分组。测量的结果是治疗后听力改善情况，将治疗前的听力学数据与治疗后第10天和> 90天的数据进行比较。使用t检验、Pearson卡方检验、Fisher精确检验以及对治疗前听力水平进行调整的多变量协方差分析对结果数据进行分析。
90多天后，对照组和研究组的平均纯音听力计（PTA）分别为54.8±31.4 dB和43±31.2 dB（P = 0.013）。对照组的听力恢复率为57.7%，研究组为69.8%。在治疗期的10天内，研究组在高频的听力增益高于对照组。根据治疗前听力水平严重程度进行分组的亚组分析表明，轻度至中度听力损失（治疗前PTA < 70 dB）患者中，研究组在所有频率的恢复率均高于对照组。然而，在重度至极重度听力损失（治疗前PTA≥70 dB）患者中，研究组和对照组的听力结果除低频外无显著差异。
本研究结果表明，与单独使用SS治疗相比，联合治疗ISSNHL可使听力恢复率更高，即使在重度听力损失患者中也是如此。
3b。《喉镜》，126:1871 - 1876，2016年。
