Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A.
Department of Biomedical Engineering, University of California, Irvine, California, U.S.A.
Laryngoscope. 2021 Jan;131(1):E283-E288. doi: 10.1002/lary.28618. Epub 2020 Apr 3.
OBJECTIVES/HYPOTHESIS: To examine the hearing outcomes of patients with sudden sensorineural hearing loss (SSNHL) treated with oral and intratympanic (IT) steroid only or a combination of steroid and migraine treatment. Our hypothesis was that adjuvant migraine medications may improve outcomes in SSNHL.
A retrospective chart review at a tertiary otology center was conducted to identify patients with SSNHL who received oral steroid and IT dexamethasone injection(s) with or without migraine medications (a combination of nortriptyline and topiramate).
A total of 47 patients received oral steroid and IT dexamethasone injection(s) only, and 46 patients received oral steroid and IT dexamethasone injection(s) as well as migraine lifestyle changes plus a combination of nortriptyline and topiramate. There were no significant differences in demographics and baseline audiometric data between the two groups. Both groups demonstrated improvements in pure tone average (PTA) and hearing thresholds at 250 Hz and 8000 Hz posttreatment. However, compared to steroid-only group, the adjuvant migraine medications group had significantly greater improvements in hearing thresholds at the lower frequencies (250 Hz, 500 Hz, 1000 Hz). Patients in the latter cohort also had greater improvement in PTA (P = .01) and received fewer IT injections (P = .04) PTA improvement of ≥ 10 dB was observed in 36 patients (78%) in the adjuvant migraine medications group and 22 patients (46%) in the control group (P < .001).
In multimodal treatment of SSNHL, supplementing oral and IT steroid with migraine medications may result in greater improvements in lower frequency hearing thresholds and PTA. Furthermore, adjuvant migraine treatment can lead to decrease in number of IT injections, thus reducing procedure-related risks and complications.
3 Laryngoscope, 131:E283-E288, 2021.
目的/假设：研究单独使用口服和鼓室内（IT）类固醇或类固醇联合偏头痛治疗治疗突发性感觉神经性听力损失（SSNHL）患者的听力结果。我们的假设是辅助偏头痛药物可能改善 SSNHL 的结果。
在一家三级耳科中心进行回顾性图表审查，以确定接受口服类固醇和 IT 地塞米松注射（加或不加偏头痛药物（曲普坦和去甲替林的组合））的 SSNHL 患者。
共有 47 名患者接受了口服类固醇和 IT 地塞米松注射，46 名患者接受了口服类固醇和 IT 地塞米松注射，以及偏头痛生活方式的改变加上曲普坦和去甲替林的组合。两组在人口统计学和基线听力数据方面没有显著差异。两组在治疗后纯音平均（PTA）和 250 Hz 和 8000 Hz 的听力阈值均有所改善。然而，与仅使用类固醇的组相比，辅助偏头痛药物组在低频（250 Hz、500 Hz、1000 Hz）的听力阈值方面有显著的改善。后者队列中的患者 PTA 也有更大的改善（P =.01），并且接受的 IT 注射更少（P =.04）。在辅助偏头痛药物组中，有 36 名患者（78%）的 PTA 改善≥10dB，而在对照组中只有 22 名患者（46%）（P <.001）。
在 SSNHL 的多模式治疗中，用偏头痛药物补充口服和 IT 类固醇可能会导致低频听力阈值和 PTA 的更大改善。此外，辅助偏头痛治疗可以减少 IT 注射的数量，从而降低与程序相关的风险和并发症。
3 级 Laryngoscope，131：E283-E288，2021 年。
