Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Acta Otolaryngol. 2020 Sep;140(9):756-760. doi: 10.1080/00016489.2020.1770331. Epub 2020 Jun 4.
Hearing recovery would be different in each sound frequency in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). To analyze frequency-specific efficacy of intratympanic steroid on ISSNHL. Of a total of 381 patients with ISSNHL (hearing threshold ≥40 dB; ≤30 days until treatment), 174 patients (174 ears) received systemic steroid plus hyperbaric oxygen therapy (HBO group), and 207 patients (208 ears) received systemic plus intratympanic steroid (IT group). Hearing thresholds at 125-8000 Hz were measured at every octave before and after treatment. % of patients with hearing gains ≥10 dB in the IT group was significantly higher for 500 Hz and the average of 5 mid-frequencies, tended to be higher for 1000 Hz, but was significantly lower for 8000 Hz, compared to the HBO group. Multiple regression analysis showed that hearing recovery was negatively correlated with patients' age for 125/2000/4000/8000 Hz and with days from onset to treatment for all frequencies, and also revealed better hearing recovery at 500/1000 Hz in the IT group than in the HBO group. Intratympanic steroid is more effective than hyperbaric oxygen to yield better hearing outcomes at mid-frequencies and would be advantageous to restore sound/speech perception. Superiority of intratympanic steroid over hyperbaric oxygen for treating ISSNHL was verified.
特发性突聋患者的听力恢复在各个频率上会有所不同。分析鼓室内类固醇治疗特发性突聋的频率特异性疗效。共有 381 例特发性突聋患者（听力阈值≥40dB；治疗前至治疗时间≤30 天），174 例患者（174 耳）接受全身类固醇加高压氧治疗（HBO 组），207 例患者（208 耳）接受全身加鼓室内类固醇（IT 组）。治疗前后每 8 倍测量 125-8000Hz 的听力阈值。与 HBO 组相比，IT 组在 500Hz 和 5 个中频的平均听力增益≥10dB 的患者比例明显更高，1000Hz 的比例倾向于更高，但 8000Hz 的比例明显更低。多元回归分析显示，听力恢复与患者年龄呈负相关，与发病至治疗的天数呈负相关，与所有频率均呈负相关，且 IT 组在 500/1000Hz 的听力恢复更好。与高压氧相比，鼓室内类固醇更能有效改善中频率的听力结果，有利于恢复声音/言语感知。验证了鼓室内类固醇治疗特发性突聋优于高压氧的优越性。
