Gachon University Gil Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Incheon, South Korea; Gachon University, College of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Incheon, South Korea.
Braz J Otorhinolaryngol. 2022 May-Jun;88(3):381-389. doi: 10.1016/j.bjorl.2020.06.017. Epub 2020 Aug 6.
Cochlear ischemia is hypothesized as one of the major etiologies of idiopathic sudden sensorineural hearing loss. Therefore, anticoagulant therapies are designed to be beneficial in certain patients with this condition.
This study aimed to determine which patients with idiopathic sudden sensorineural hearing loss would benefit from heparin treatment as adjuvant therapy.
In total, 134 patients who underwent magnetic resonance imaging for unilateral idiopathic sudden sensorineural hearing loss at a tertiary referral hospital between January 2014 and December 2018 were included in this retrospective study. All patients received Intratympanic steroid injections or heparin therapy plus oral corticosteroids. Radiological parameters of the vertebrobasilar system and clinical data from pre- and post-treatment assessments were analyzed.
Most patients (71.6%) had a tortuous basilar artery The 65 patients with severe-to-profound idiopathic sudden sensorineural hearing loss showed a significant relationship between idiopathic sudden sensorineural hearing loss laterality and basilar artery displacement to the opposite side (p = 0.036), while the 69 patients with mild-to-moderate idiopathic sudden sensorineural hearing loss did not (p = 0.950). Additionally, the degree of basilar artery tortuosity was significantly associated with the degree of hearing impairment in the severe-to-profound idiopathic sudden sensorineural hearing loss group (p = 0.015). When idiopathic sudden sensorineural hearing loss occurred on the opposite side to basilar artery displacement, the improvement of hearing was significantly greater in patients treated with heparin than in those treated with intratympanic steroids (p = 0.041).
In a subset of patients with severe-to-profound idiopathic sudden sensorineural hearing loss, basilar artery tortuosity had a significant directional relationship with idiopathic sudden sensorineural hearing loss laterality. In these selected patients, a significant effect of heparin therapy on improving hearing was observed.
耳蜗缺血被认为是特发性突发性聋的主要病因之一。因此，抗凝治疗旨在为某些患有这种疾病的患者带来益处。
本研究旨在确定哪些特发性突发性聋患者将从肝素治疗中受益作为辅助治疗。
在一家三级转诊医院，2014 年 1 月至 2018 年 12 月期间，对 134 例单侧特发性突发性聋患者进行磁共振成像检查，纳入本回顾性研究。所有患者均接受鼓室内皮质类固醇注射或肝素治疗联合口服皮质类固醇治疗。分析椎基底动脉系统的影像学参数和治疗前后的临床数据。
大多数患者（71.6%）有一个扭曲的基底动脉。65 例重度至极重度特发性突发性聋患者的特发性突发性聋侧与基底动脉向对侧移位之间存在显著关系（p=0.036），而 69 例轻度至中度特发性突发性聋患者则没有（p=0.950）。此外，基底动脉扭曲程度与重度至极重度特发性突发性聋患者的听力损失程度显著相关（p=0.015）。当特发性突发性聋发生在基底动脉移位的对侧时，肝素治疗组患者的听力改善明显大于鼓室内类固醇治疗组（p=0.041）。
在一组重度至极重度特发性突发性聋患者中，基底动脉扭曲与特发性突发性聋侧有显著的方向性关系。在这些选定的患者中，肝素治疗对改善听力有显著的效果。
