Almosnino Galit, Holm James R, Schwartz Seth R, Zeitler Daniel M
1 Department of Otolaryngology/Head and Neck Surgery, Section of Otology/Neurotology, Virginia Mason Medical Center, Seattle, Washington, USA.
2 Center for Hyperbaric Medicine, Department of Medicine, Virginia Mason Medical Center, Seattle, Washington, USA.
Ann Otol Rhinol Laryngol. 2018 Oct;127(10):672-676. doi: 10.1177/0003489418787832. Epub 2018 Jul 15.
We sought to evaluate hearing outcomes after salvage therapy with hyperbaric oxygen (HBO2) for the treatment of sudden sensorineural hearing loss (SSNHL).
Matched control retrospective case series.
Tertiary neurotology referral center.
Thirty-six patients (>18 years) diagnosed with SSNHL.
Patients received initial therapy with oral and/or intratympanic (IT) steroids with an incomplete response. Eighteen patients underwent salvage therapy with IT steroids and HBO2 (group 1). Eighteen matched controls underwent salvage therapy with IT steroids alone (group 2).
The main outcome measure was improvement in pure tone average (PTA) and word recognition score (WRS). Complications as a result of therapy were also monitored.
There were no significant differences in age, gender, or hearing between the 2 groups ( P > .05). There was no significant difference in mean post-treatment PTA between group 1 (60.3 dB) and group 2 (53.2 dB). There were no significant difference in mean post-treatment WRS between group 1 (42%) and group 2 (51%). Serviceable hearing was defined as a minimum WRS of 50%. Thirty-three percent in group 1 and 42% in group 2 went from nonserviceable hearing to serviceable hearing ( P > .05). PTA and WRS change scores were not significantly affected by age, gender, form of initial treatment, or pre-treatment PTA and WRS.
The present study demonstrated no significant difference in hearing outcomes between patients receiving salvage therapy with HBO2 and IT steroids compared to patients receiving IT steroids alone. Larger, prospective randomized trials are needed to better define the role of HBO2 as salvage therapy for SSNHL.
我们旨在评估高压氧（HBO2）挽救性治疗突发性感音神经性听力损失（SSNHL）后的听力结果。
配对对照回顾性病例系列研究。
三级神经耳科学转诊中心。
36例年龄大于18岁、被诊断为SSNHL的患者。
患者接受口服和/或鼓室内（IT）类固醇初始治疗但反应不完全。18例患者接受IT类固醇和HBO2挽救性治疗（第1组）。18例配对对照患者仅接受IT类固醇挽救性治疗（第2组）。
主要观察指标为纯音平均听阈（PTA）和言语识别率（WRS）的改善情况。同时监测治疗引起的并发症。
两组患者在年龄、性别或听力方面无显著差异（P>.05）。第1组（60.3 dB）和第2组（53.2 dB）治疗后的平均PTA无显著差异。第1组（42%）和第2组（51%）治疗后的平均WRS无显著差异。有效听力定义为WRS至少为50%。第1组33%的患者和第2组42%的患者从无效听力转变为有效听力（P>.05）。PTA和WRS变化分数不受年龄、性别、初始治疗形式或治疗前PTA和WRS的显著影响。
本研究表明，与仅接受IT类固醇治疗的患者相比，接受HBO2和IT类固醇挽救性治疗的患者在听力结果上无显著差异。需要开展更大规模的前瞻性随机试验，以更好地明确HBO2作为SSNHL挽救性治疗的作用。
