Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic.
Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic.
Int J Environ Res Public Health. 2021 Apr 22;18(9):4460. doi: 10.3390/ijerph18094460.
Acute acoustic trauma (AAT) ranks, among others, as one common cause of inner ear function impairment, especially in terms of military personnel, who are at an increased exposure to impulse noises from firearms.
We retrospectively analyzed data for the period 2004-2019 in patients with AAT. We evaluated the therapeutic success of corticosteroids and HBO2 in a cohort of patients with AAT n = 108 patients/n = 141 affected ears.
Hearing improvement after treatment was recorded in a total of 111 ears (79%). In terms of the data analysis we were able to ascertain, utilizing success of treatment versus timing: within 24 h following the onset of therapy in 56 (40%) ears-54 (96%) ears had improved; within seven days following the onset the therapy was used in 55 (39%) ears-41 (74%) ears had improved; after seven days the therapy started in 30 (21%) ears-16 (53%) ears had improved. Parameter latency of the beginning of the treatment of AAT was statistically significant ( = 0.001 and 0.017, respectively). The success of the medical protocols was apparent in both groups-group I (treated without HBO2): n = 61 ears, of which 50 (82%) improved, group II (treated with HBO2): n = 73 ears, of which 56 (77%) improved. Group II shows improvement at most frequencies (500-2000 Hz). The most serious sensorineural hearing loss after AAT was at a frequency of 6000 Hz.
Analysis of our data shows that there is a statistically significant higher rate of improvement if AAT treatment was initiated within the first seven days after acoustic trauma. Early treatment of AAT leads to better treatment success. HBO2 is considered a rescue therapy for the treatment of AAT. According to our recommendation, it is desirable to start corticosteroid therapy immediately after acoustic trauma. If hearing does not improve during the first seven days of corticosteroid therapy, then HBO2 treatment should be initiated.
急性声创伤（AAT）是内耳功能损害的常见原因之一，尤其是在军事人员中，他们更容易受到枪支产生的脉冲噪声的影响。
我们回顾性分析了 2004 年至 2019 年期间患有 AAT 的患者的数据。我们评估了皮质类固醇和 HBO2 在 AAT 患者队列中的治疗效果，共 108 例患者/141 只受累耳。
共有 111 只（79%）耳朵在治疗后听力改善。根据数据分析，我们确定了治疗成功与时间的关系：在治疗开始后 24 小时内，56 只（40%）耳朵-54 只（96%）耳朵听力改善；在治疗开始后七天内，55 只（39%）耳朵-41 只（74%）耳朵听力改善；在治疗开始后七天内，30 只（21%）耳朵-16 只（53%）耳朵听力改善。AAT 治疗开始时的潜伏期参数具有统计学意义（=0.001 和 0.017）。两组的医疗方案均有效：组 I（未接受 HBO2 治疗）：n=61 只耳朵，其中 50 只（82%）改善；组 II（接受 HBO2 治疗）：n=73 只耳朵，其中 56 只（77%）改善。组 II 在大多数频率（500-2000 Hz）都有改善。AAT 后最严重的感音神经性听力损失发生在 6000 Hz 频率。
分析我们的数据显示，如果在声创伤后 7 天内开始 AAT 治疗，听力改善的比率有统计学意义的提高。AAT 的早期治疗可导致更好的治疗效果。HBO2 被认为是治疗 AAT 的抢救治疗方法。根据我们的建议，在发生声创伤后立即开始皮质类固醇治疗是理想的。如果皮质类固醇治疗的前七天听力没有改善，应开始 HBO2 治疗。
