Skarzynska Magdalena Beata, Kolodziejak Aleksandra, Gos Elżbieta, Skarzynski Piotr Henryk, Lorens Artur, Walkowiak Adam
Institute of Sensory Organs, Nadarzyn, 05-830 Warsaw, Poland.
Center of Hearing and Speech Medincus, Kajetany, 05-830 Warsaw, Poland.
Life (Basel). 2022 Mar 27;12(4):486. doi: 10.3390/life12040486.
(1) Background: The main aim of this study was to assess the clinical effectiveness of two different schemes of administration of steroids ((1) dexamethasone administered intravenously in comparison with (2) combination of steroid treatments: orally administered prednisone and intravenously administered dexamethasone) in comparison with a control group (no steroid administration) on hearing preservation (HP) in patients who underwent an Advanced Bionics cochlear implantation. (2) Methods: Thirty-five adult patients met the inclusion criteria. All patients were randomly divided into three subgroups depending on the scheme of steroid administration: (1) the first subgroup with only intravenously administered dexamethasone (0.1 mg per kg body weight twice a day for three days), (2) the second subgroup with a combination of methods of administration of steroids (intravenous and oral steroid therapy (dexamethasone, 0.1 mg/kg body weight twice a day plus prednisone, 1 mg/kg weight once a day for three days before surgery and after administration of dexamethasone (4th, 5th, 6th day) and after this time the dose of prednisone was reduced)) and (3) the third subgroup without steroid therapy (control group). The results were measured by pure tone audiometry (PTA) in three periods: (1) before implantation, (2) during activation of the processor (one month after implantation), and (3) 12 months after activation. Patients' hearing thresholds before implantation were on average 82 dB HL, 77 dB HL, and 88 dB HL, respectively. (3) Results: The majority of the patients from the first subgroup had hearing preserved partially (77.8%). A similar result was observed in the second study group (oral + i.v.) (partial hearing preservation was found in 61.5% of the participants). The opposite was true in the control group; a plurality of control patients (38.5%) had no measurable hearing 12 months after the activation of the processor. (4) Conclusions: Pharmacological treatment consisting of the administration of steroids in patients who had undergone cochlear implantation with the Advanced Bionics HiRes Ultra 3D cochlear implant system may be beneficial for preserving residual hearing in patients.
（1）背景：本研究的主要目的是评估两种不同类固醇给药方案（（1）静脉注射地塞米松与（2）类固醇联合治疗：口服泼尼松和静脉注射地塞米松）与对照组（不使用类固醇）相比，对接受先进生物电子公司人工耳蜗植入的患者听力保留（HP）的临床效果。（2）方法：35名成年患者符合纳入标准。所有患者根据类固醇给药方案随机分为三个亚组：（1）第一亚组仅静脉注射地塞米松（0.1毫克/千克体重，每天两次，共三天），（2）第二亚组采用类固醇联合给药方法（静脉和口服类固醇治疗（地塞米松，0.1毫克/千克体重，每天两次，加泼尼松，1毫克/千克体重，在手术前和地塞米松给药后（第4、5、6天）每天一次，共三天，此后泼尼松剂量减少）），（3）第三亚组不进行类固醇治疗（对照组）。结果通过纯音听力测定（PTA）在三个阶段进行测量：（1）植入前，（2）处理器激活期间（植入后一个月），以及（3）激活后12个月。植入前患者的听力阈值平均分别为82分贝HL、77分贝HL和88分贝HL。（3）结果：第一亚组的大多数患者部分听力得以保留（77.8%）。在第二个研究组（口服+静脉注射）中也观察到了类似结果（61.5%的参与者发现部分听力保留）。对照组则相反；在处理器激活12个月后，多个对照患者（38.5%）没有可测量的听力。（4）结论：对于接受先进生物电子公司HiRes Ultra 3D人工耳蜗植入系统的人工耳蜗植入患者，使用类固醇进行药物治疗可能有利于保留患者的残余听力。
