2nd Academic ENT Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece.
1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
Am J Otolaryngol. 2022 Sep-Oct;43(5):103564. doi: 10.1016/j.amjoto.2022.103564. Epub 2022 Aug 3.
To evaluate the therapeutic effect of the combination of systemic steroids (SS) and hyperbaric oxygen therapy (HBOT) in patients with idiopathic sudden sensorineural hearing loss (SSNHL).
Fifty patients with idiopathic sudden sensorineural hearing loss were allocated into 2 groups: the control group received Dexamethasone IV (SS) and the therapy group received Dexamethasone IV combined with 15 sessions of hyperbaric oxygen therapy (SS + HBOT) as initial treatment. Hearing assessment was performed at the admission to hospital and 3 months after the onset of treatment. Siegel's criteria were used to evaluate the hearing outcomes. Prognostic factors were identified by linear regression analyses.
Hearing improvement rate was 64 % in the therapy group and 56 % in the control group, difference which was not statistically significant (p = 0.369). Furthermore, when patients of each group were categorized into 5 subgroups by disease severity (mild, moderate, moderate to severe, severe, profound), differences in treatment outcome between the subgroups of the same severity were not significant. A descending type audiogram curve was proven an unfavorable prognostic factor in both groups, as it led to a significantly lower hearing gain (30 dB) compared to other curve shapes (b = -29.10, 95 % CI = -56.39, -1.82).
The addition of hyperbaric oxygen therapy to systemic steroids caused no significant hearing improvement, despite a mild tendency toward a greater improvement rate within the combination group. More prospective randomized trials with larger series of patients could shed even more light on the effectiveness of combination therapy (SS + HBOT) in patients affected by SSNHL.
评估全身类固醇（SS）联合高压氧治疗（HBOT）在特发性突发性聋（SSNHL）患者中的疗效。
将 50 例特发性突发性聋患者分为两组：对照组给予地塞米松静脉滴注（SS），治疗组给予地塞米松静脉滴注联合 15 次高压氧治疗（SS+HBOT）作为初始治疗。在入院时和治疗开始后 3 个月进行听力评估。采用 Siegel 标准评估听力结果。通过线性回归分析确定预后因素。
治疗组听力改善率为 64%，对照组为 56%，差异无统计学意义（p=0.369）。此外，当根据疾病严重程度（轻度、中度、中重度、重度、极重度）将每组患者分为 5 个亚组时，同一严重程度亚组之间的治疗效果差异无统计学意义。下降型听力图曲线被证明是两组的不利预后因素，与其他曲线形状相比，其听力增益显著降低（30dB）（b=-29.10，95%CI=-56.39，-1.82）。
尽管联合组的改善率有轻微增加的趋势，但高压氧治疗联合全身类固醇治疗并未显著改善听力。更多前瞻性随机试验和更大系列的患者可能会进一步阐明联合治疗（SS+HBOT）对 SSNHL 患者的有效性。
