Department of Otorhinolaryngology, ROK Armed Forces Yangju Hospital, Yangju.
Department of Otorhinolaryngology, ROK Armed Forces Capital Hospital, Bundang.
Otol Neurotol. 2018 Jun;39(5):565-570. doi: 10.1097/MAO.0000000000001784.
To analyze the factors associated with the benefits of concurrent administration of intratympanic steroid injection (ITSI) and oral steroids in patients with acute acoustic trauma (AAT) incurred during military training.
Retrospective analysis.
Nineteen patients eligible under the criteria established concerning treatment for AAT were retrospectively reviewed in this study.
ITSI treatments were administered simultaneously alongside oral prednisolone.
Patients were categorized into two groups depending on the time elapsed between exposure to the noise and treatment initiation: 1) "Early Treatment initiation," defined as the treatment being initiated between 3 and 7 days; and 2) "Delayed treatment initiation," defined as the treatment being initiated in >7 days. Pure-tone air conduction threshold audiometry, to record the pure-tone average (PTA) at 2, 4, and 8 kHz, was conducted upon each patient's initial visit, and 1 month after starting treatment. The degree of hearing gain (hearing gain [dB] = [initial PTA] - [final PTA]) was calculated and used as the metric for determining the treatment's outcome. The initial PTA and treatment onset were adopted as possible associated factors.
The mean ages of each group were 22.00 ± 2.12 years and 22.83 ± 2.64 years, respectively (p = 0.28). The initial PTAs were 46.41 ± 12.73 dB and 47.22 ± 14.74 dB, respectively (p = 1.00).In the multivariable linear regression analysis, the initial PTA and the treatment initiation showed a significant association (R = 0.37). The unstandardized regression coefficient of the initial PTA was 0.37 (p = 0.04). Patients with early treatment initiation showed significant improvement in the degree of hearing gain compared with delayed treatment initiation (unstandardized regression coefficient = 12.63, p = 0.01).
We demonstrated the importance of early treatment onset for maximizing the benefits of concurrent administration of ITSI with oral steroids in patients with AAT suffered during military training. Further evaluation is needed to confirm the factors associated with the efficacy of concurrent ITSI with oral steroids.
分析与军事训练期间发生的急性声创伤（AAT）患者同时接受鼓室内类固醇注射（ITSI）和口服类固醇治疗的益处相关的因素。
回顾性分析。
符合 AAT 治疗标准的 19 名患者被纳入本研究。
同时进行 ITI 治疗和口服泼尼松龙治疗。
根据暴露于噪声与治疗开始之间的时间长短，将患者分为两组：1）“早期治疗开始”定义为治疗开始于 3 至 7 天之间；2）“延迟治疗开始”定义为治疗开始于 7 天以后。每位患者在初次就诊和开始治疗后 1 个月时，进行纯音空气传导阈值测听，记录 2、4 和 8 kHz 的纯音平均听阈（PTA）。计算听力增益（听力增益[dB]=[初始 PTA]-[最终 PTA]）作为评估治疗效果的指标。初始 PTA 和治疗开始时间被用作可能的相关因素。
两组患者的平均年龄分别为 22.00±2.12 岁和 22.83±2.64 岁（p=0.28）。初始 PTA 分别为 46.41±12.73 dB 和 47.22±14.74 dB（p=1.00）。多元线性回归分析显示，初始 PTA 和治疗开始时间存在显著相关性（R=0.37）。初始 PTA 的未标准化回归系数为 0.37（p=0.04）。与延迟治疗开始相比，早期治疗开始的患者听力增益程度显著改善（未标准化回归系数=12.63，p=0.01）。
我们证明了军事训练期间发生的 AAT 患者同时接受 ITI 和口服类固醇治疗时，早期开始治疗对于最大限度地提高治疗效果至关重要。需要进一步评估以确认与同时进行 ITI 和口服类固醇治疗疗效相关的因素。
