初始治疗对特发性突发性感音神经性听力损失听力预后的影响：日本全国性调查
The effect of initial treatment on hearing prognosis in idiopathic sudden sensorineural hearing loss: a nationwide survey in Japan.
作者信息
Okada Masahiro, Hato Naohito, Nishio Shin-Ya, Kitoh Ryosuke, Ogawa Kaoru, Kanzaki Sho, Sone Michihiko, Fukuda Satoshi, Hara Akira, Ikezono Tetsuo, Ishikawa Kotaro, Iwasaki Satoshi, Kaga Kimitaka, Kakehata Seiji, Matsubara Atsushi, Matsunaga Tatsuo, Murata Takaaki, Naito Yasushi, Nakagawa Takashi, Nishizaki Kazunori, Noguchi Yoshihiro, Sano Hajime, Sato Hiroaki, Suzuki Mikio, Shojaku Hideo, Takahashi Haruo, Takeda Hidehiko, Tono Tetsuya, Yamashita Hiroshi, Yamasoba Tatsuya, Usami Shin-Ichi
机构信息
a Department of Otolaryngology , Ehime University School of Medicine , Toon , Japan.
b Department of Otorhinolaryngology , Shinshu University School of Medicine , Matsumoto , Japan.
出版信息
Acta Otolaryngol. 2017;137(sup565):S30-S33. doi: 10.1080/00016489.2017.1296970. Epub 2017 Mar 31.
OBJECTIVE
To investigate the hearing prognosis of idiopathic sudden sensorineural hearing loss (SSNHL) treated with different initial therapies.
METHODS
Subjects consisted of patients diagnosed with idiopathic SSNHL within 7 days from onset and showing severe hearing loss (≥60 dB), who were registered in a Japanese multicenter database between April 2014 and March 2016. Subjects were divided into four groups according to initial therapy: (1) steroids, (2) steroids + Prostaglandins (PGs), (3) intratympanic steroids (ITS), and (4) no steroids. Hearing outcomes were compared among the groups.
RESULTS
In total, 1305 patients were enrolled. The final hearing level and hearing gain of patients treated with steroids + PGs were significantly higher than those of patients treated with steroids alone or no steroids. The ratio of good prognosis (complete recovery or marked improvement) in patients treated with steroids + PGs was higher than that in patients treated with steroids alone or no steroids. There was no difference in the prognosis of patients treated with steroids alone or no steroids.
CONCLUSION
A large number of patients with idiopathic SSNHL were registered in a multicenter database. PG use in combination with steroid administration was associated with a good hearing prognosis in patients with severe hearing loss.
目的
探讨采用不同初始治疗方法治疗的特发性突发性感音神经性听力损失（SSNHL）的听力预后情况。
方法
研究对象为2014年4月至2016年3月期间登记在日本多中心数据库中的、发病7天内被诊断为特发性SSNHL且表现为重度听力损失（≥60dB）的患者。根据初始治疗方法将研究对象分为四组：（1）类固醇；（2）类固醇+前列腺素（PGs）；（3）鼓室内类固醇（ITS）；（4）不使用类固醇。比较各组的听力结果。
结果
共纳入1305例患者。接受类固醇+PGs治疗的患者的最终听力水平和听力增益显著高于单独使用类固醇或不使用类固醇治疗的患者。接受类固醇+PGs治疗的患者的良好预后（完全恢复或明显改善）比例高于单独使用类固醇或不使用类固醇治疗的患者。单独使用类固醇或不使用类固醇治疗的患者的预后无差异。
结论
多中心数据库中登记了大量特发性SSNHL患者。对于重度听力损失患者，联合使用PG与类固醇给药与良好的听力预后相关。
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