Shin Seung-Ho, Byun Sung Wan, Park Sohl, Kim Eun Hye, Kim Min Woo, Lee Ho Yun
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, Korea.
Department of Otorhinolaryngology, Daejeon Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Korea.
J Audiol Otol. 2021 Oct;25(4):209-216. doi: 10.7874/jao.2021.00269. Epub 2021 Jun 30.
We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results.
We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital's otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated.
Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results.
A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.
我们旨在分析不同初始治疗方法后的治疗效果，并确定能产生最佳效果的急性低频感音神经性听力损失（ALHL）的治疗方案。
我们回顾性分析了2013年3月至2019年6月期间到某大学医院耳科门诊就诊的106例ALHL患者的病历。评估了初诊时以及初诊后2周和4周时的纯音平均听阈。
本研究纳入49例患者；其中，41例（83.7%）在初诊后2周时完全恢复（CR），43例（87.8%）在初诊后1个月时完全恢复。回归分析显示，初诊后2周时的完全恢复与使用利尿剂有关[指数(B)：10.309，95%置信区间(CI)：1.007 - 100]。初始每日低剂量使用类固醇具有边缘显著性[指数(B)：1.042，95% CI：0.997 - 1.092；p = 0.066]。单独使用利尿剂[指数(B)：25.641，95% CI：1.121 - 90.909；p = 0.039]是初诊后1个月时的独立良好预后因素。然而，其他治疗方案并未影响最终结果。
初始每日给予≤30 mg泼尼松龙加利尿剂联合使用足以作为ALHL的一线治疗。高剂量类固醇和挽救性鼓室内注射类固醇可作为第二选择；然而，在这种情况下预测效果不佳。
