Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea.
Laryngoscope. 2020 May;130(5):1310-1315. doi: 10.1002/lary.28231. Epub 2019 Aug 9.
OBJECTIVES/HYPOTHESIS: This study aimed to provide evidence of whether unfractionated heparin used as adjuvant therapy in conjunction with systemic corticosteroid therapy improves hearing recovery in patients with profound idiopathic sudden sensorineural hearing loss (ISSNHL), and to compare the effect of this treatment with those of additional intratympanic corticosteroid therapy.
Retrospective chart review.
Eighty-seven patients with profound ISSNHL (≥90 dB) and who had been admitted at a tertiary referral center between 2010 and 2018 were retrospectively reviewed, 67 patients for additional intratympanic corticosteroid injection (ITSI) (ITSI group) and 21 for adjuvant heparin therapy (heparin group). Hearing recovery was evaluated by grade assessment according to the American Academy of Otolaryngology-Head and Neck Surgery criteria.
Of the patients in the heparin group, 42.8% recovered serviceable hearing, which was significantly higher than the recovery rates (19.7%) of those in the ITSI group. Particularly, in patients with pretreatment hearing level of 90 to 100 dB, adjuvant heparin therapy enhanced therapeutic effects with a significant hearing recovery rate of 80%. However, in patients with initial hearing level >100 dB, the rates of significant hearing recovery in the two groups were roughly equal and remained unsatisfactory (8.1% in the ITSI group and 9.1% in the heparin group).
The results of this study suggest that the treatment of profound ISSNHL with adjuvant heparin therapy, in combination with systemic steroid therapy, results in higher hearing recovery rates when compared to combined local and systemic corticosteroid therapy, without serious complications.
3b Laryngoscope, 130:1310-1315, 2020.
目的/假设：本研究旨在提供证据，证明在全身性皮质类固醇治疗的基础上联合使用未分级肝素作为辅助治疗是否能改善特发性突发性重度感音神经性聋（ISSNHL）患者的听力恢复，并比较这种治疗方法与额外鼓室内皮质类固醇治疗的效果。
回顾性图表审查。
回顾性分析了 2010 年至 2018 年在一家三级转诊中心住院的 87 例特发性重度 ISSNHL（≥90dB）患者的病历，其中 67 例接受了额外鼓室内皮质类固醇注射（ITSI）（ITSI 组），21 例接受了辅助肝素治疗（肝素组）。根据美国耳鼻喉科学-头颈外科学会（AAO-HNS）标准进行分级评估，评估听力恢复情况。
肝素组中有 42.8%的患者恢复了可利用的听力，明显高于 ITSI 组（19.7%）的恢复率。特别是在治疗前听力水平为 90-100dB 的患者中，辅助肝素治疗增强了治疗效果，听力恢复率显著提高到 80%。然而，在初始听力水平>100dB 的患者中，两组的显著听力恢复率大致相同且仍不理想（ITSI 组为 8.1%，肝素组为 9.1%）。
本研究结果表明，与局部和全身皮质类固醇联合治疗相比，联合全身皮质类固醇治疗和辅助肝素治疗特发性重度 ISSNHL 可提高听力恢复率，且无严重并发症。
3b Laryngoscope, 130:1310-1315, 2020.
