鼓室内类固醇或高压氧治疗联合全身类固醇治疗突发性特发性感音神经性听力损失，以及挽救治疗的长期结果。
Addition of intratympanic steroid or hyperbaric oxygen treatment to systemic steroid treatment in sudden idiopathic sensorineural hearing loss treatment, and long-term results of salvage treatment.
机构信息
Department of Otolaryngology, University of Medical Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
Department of Otolaryngology, Balıkesir State Hospital, Balıkesir, Turkey
出版信息
Turk J Med Sci. 2020 Feb 13;50(1):177-183. doi: 10.3906/sag-1908-122.
BACKGROUND/AIM: This study aims to determine the therapeutic superiority of the addition of intratympanic steroid or hyperbaric oxygen therapy to systemic steroid treatment in idiopathic sudden sensorineural hearing loss as initial treatment, and evaluate the long- term results of salvage treatment.
MATERIALS AND METHODS
This study was a retrospective clinical trial with a total of 96 patients with idiopathic sudden sensorineural hearing loss. Patients were divided into 3 groups. Group 1 (n: 32) received systemic steroid treatment. Group 2 (n: 32) received the Group 1 protocol plus intratympanic steroid treatment. Group 3 (n: 32) received the Group 1 protocol plus hyperbaric oxygen treatment. Pretreatment and postinitial audiologic evaluations were performed, and the hearing outcome was analyzed with Furuhashi criteria. All patients, except those who experienced total recovery after initial treatment, were directed to salvage treatment. Audiologic assessment was performed again after salvage treatment and a mean follow-up period of 36.5 months.
RESULTS
Each group was homogenous according to demographics, audiologic data, and prognostic factors. There was no statistically significant difference in recovery and success rate within the 3 groups after initial treatment. (P: 0.66, P: 0.248, respectively). Successful results were obtained after salvage treatment in only 3 patients (5%). These patients received follow-up treatment at a mean of 36.5 months, but there was no spontaneous recovery after the end of salvage treatment.
CONCLUSION
The addition of intratympanic steroids or hyperbaric oxygen to systemic steroids caused no significant hearing improvement as the initial treatment of idiopathic sudden sensorineural hearing loss. The efficacy of salvage treatment was limited, and there was no spontaneous hearing improvement after the long-term follow-up.
背景/目的：本研究旨在确定作为初始治疗，鼓室内类固醇或高压氧治疗与全身类固醇治疗联合治疗特发性突发性聋的治疗优越性，并评估挽救治疗的长期结果。
材料和方法
这是一项回顾性临床试验，共纳入 96 例特发性突发性聋患者。患者分为 3 组。第 1 组（n：32）接受全身类固醇治疗。第 2 组（n：32）接受第 1 组方案加鼓室内类固醇治疗。第 3 组（n：32）接受第 1 组方案加高压氧治疗。进行预处理和初始听力评估，并根据 Furuhashi 标准分析听力结果。除初始治疗后完全恢复的患者外，所有患者均进行挽救治疗。挽救治疗后再次进行听力评估，平均随访 36.5 个月。
结果
每组在人口统计学、听力数据和预后因素方面均具有同质性。初始治疗后 3 组之间的恢复和成功率无统计学差异。（P：0.66，P：0.248）。仅 3 例（5%）患者在挽救治疗后获得成功结果。这些患者在平均 36.5 个月时接受了随访治疗，但挽救治疗结束后没有自发恢复。
结论
作为特发性突发性聋的初始治疗，鼓室内类固醇或高压氧治疗联合全身类固醇治疗并未显著改善听力。挽救治疗的疗效有限，长期随访后无自发听力改善。
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