Wang Xiangsheng, Jiang Ruirui, Su Jiang
Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xin Jiang Medical University , Urumchi , China.
Department of Pharmacy, Urumqi Municipal First People's Hospital , Urumchi , China.
Acta Otolaryngol. 2019 Nov;139(11):1004-1007. doi: 10.1080/00016489.2019.1659516. Epub 2019 Sep 5.
Patients with end-stage renal disease (ESRD) have a higher risk of suffering sudden sensorineural hearing loss (SSNHL), but little is known about this population. To investigate the clinical characteristics, treatment and recovery of SSNHL patients with ESRD. Records of 32 SSNHL patients with ESRD were reviewed, including clinical characteristics and hearing recovery. Patients were divided into intratympanic steroid (ITS) group and oral steroid (OS) group, and hearing recovery was compared between two groups. Twenty-six patients (81.3%) exhibited tinnitus, and 18 patients (56.3%) suffered vertigo. Mean pure-tone threshold at the initial presentation was 73.2 ± 19.4 dB, and the audiogram configuration was ascending in 9.4%, descending in 9.4%, flat in 34.4% and profound in 46.9% cases. At 3-month follow-up, percentages of patients in complete recovery, partial recovery, slight recovery, and no improvement were 18.8%, 31.3%, 21.9% and 28.1%, respectively. Furthermore, the overall recovery rate, complete recovery rate and hearing improvement were significantly higher in the ITS group than those in the OS group. SSNHL patient with ESRD often suffered a severe hearing loss with a high rate of accompanying tinnitus and vertigo. ITS may provide better audiological results for SSNHL with ESRD than OS.
终末期肾病(ESRD)患者突发感音神经性听力损失(SSNHL)的风险较高,但对此类人群了解甚少。本研究旨在调查ESRD合并SSNHL患者的临床特征、治疗及恢复情况。回顾了32例ESRD合并SSNHL患者的病历,包括临床特征及听力恢复情况。将患者分为鼓室内注射类固醇(ITS)组和口服类固醇(OS)组,比较两组的听力恢复情况。26例患者(81.3%)出现耳鸣,18例患者(56.3%)出现眩晕。初次就诊时平均纯音听阈为73.2±19.4dB,听力图类型呈上升型的占9.4%,下降型的占9.4%,平坦型的占34.4%,极重度型的占46.9%。在3个月的随访中,完全恢复、部分恢复、轻度恢复和无改善的患者比例分别为18.8%、31.3%、21.9%和28.1%。此外,ITS组的总体恢复率、完全恢复率及听力改善情况均显著高于OS组。ESRD合并SSNHL患者常伴有严重听力损失,耳鸣和眩晕发生率高。对于ESRD合并SSNHL患者,ITS可能比OS提供更好的听力学结果。