Ajduk Jakov, Košec Andro, Kelava Iva, Ries Mihael, Gregurić Tomislav, Kalogjera Livije
School of Medicine, University of Zagreb, Croatia.
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre milosrdnice, Zagreb, Croatia.
Am J Audiol. 2019 Jun 10;28(2):315-321. doi: 10.1044/2019_AJA-18-0127. Epub 2019 May 14.
Purpose This article investigates the possible connections between the level of chronic stress and success of steroid therapy in patients with sudden sensorineural hearing loss (SSNHL). Method A single-center, retrospective, longitudinal cohort study on 55 patients in a tertiary referral otology center was examined. Patients diagnosed with SSNHL between 2014 and 2017 were asked to complete a Measure of Perceived Stress (Brajac, Tkalcic, Dragojević, & Gruber, 2003 ) questionnaire. Inclusion criteria were patients > 18 years of age, SSNHL diagnosed within 4 previous weeks, completed steroid treatment, and complete documentation. Results There were 30 patients (55%) that showed significant improvement in their pure-tone audiogram (PTA) hearing threshold average (≥ 15 dB) after steroid treatment. Two-step cluster analysis identified 3 clusters based on average PTA hearing threshold recovery and average Measure of Perceived Stress scores. The difference between pretreatment and posttreatment hearing levels was significantly higher in the cluster with moderate stress compared to clusters with mild and high stress levels (Kruskal-Wallis test, Friedman test, p < .001). There were no significant differences in average PTA hearing threshold recovery after steroid therapy between groups of patients with mild and severe stress. Conclusion Patients with moderate stress levels show significantly better results after steroid treatment for SSNHL than patients with low or high stress levels.
目的 本文探讨慢性应激水平与突发性感音神经性听力损失（SSNHL）患者类固醇治疗成功率之间的可能联系。方法 对一家三级转诊耳科中心的55例患者进行了单中心、回顾性纵向队列研究。要求在2014年至2017年期间被诊断为SSNHL的患者完成一份感知压力量表（Brajac、Tkalcic、Dragojević和Gruber，2003）问卷。纳入标准为年龄大于18岁、在之前4周内被诊断为SSNHL、完成类固醇治疗且有完整记录。结果 30例患者（55%）在类固醇治疗后纯音听力图（PTA）听力阈值平均改善显著（≥15 dB）。两步聚类分析根据平均PTA听力阈值恢复情况和平均感知压力量表得分确定了3个聚类。与轻度和高度应激聚类相比，中度应激聚类中治疗前和治疗后听力水平的差异显著更高（Kruskal-Wallis检验、Friedman检验，p<0.001）。轻度和重度应激患者组在类固醇治疗后平均PTA听力阈值恢复方面无显著差异。结论 对于SSNHL，中度应激水平的患者在接受类固醇治疗后的效果明显优于低应激或高应激水平的患者。
