Department of Otolaryngology, St. Marianna University.
Department of Otolaryngology, Toho University Omori Medical Center.
Otol Neurotol. 2023 Dec 1;44(10):983-987. doi: 10.1097/MAO.0000000000004035. Epub 2023 Oct 19.
This study evaluated the therapeutic effect of hyperbaric oxygen therapy (HBOT) combined with steroid therapy to treat sudden hearing loss and examined the index associated with excellent therapeutic effect.
We included 109 patients with sudden hearing loss. Patients were divided into the HBOT combination group (59 sides) treated with HBOT and steroid therapy and HBOT noncombination group (50 sides) involving steroid therapy only. The recovery rate of each group was compared according to the severity of hearing loss. Blood samples were evaluated and inflammatory markers, such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), were calculated and compared by severity. We evaluated the usefulness of inflammatory markers for predicting recovery rate, and calculated cutoff values were also evaluated.
The HBOT combination group exhibited a higher overall recovery rate than the HBOT noncombination group, particularly in severe cases. However, there was no significant difference in the severity of hearing loss based on various inflammatory markers. NLR and PLR are useful for predicting the effect in patients treated with concomitant HBOT. By setting 2.43 and 146.67 as cutoff values for NLR and PLR, respectively, we observed that lower values resulted in better recovery rates.
The use of HBOT is effective for severe cases and early blood flow disorders with low NLR and PLR and less inflammation. When determining treatment, not only should the severity of hearing loss be considered, but also the NLR and PLR should be evaluated and examined based on the cutoff values.
本研究评估高压氧治疗(HBOT)联合激素治疗突发性聋的疗效,并探讨与良好疗效相关的指标。
共纳入 109 例突发性聋患者。患者分为 HBOT 联合组(59 侧),接受 HBOT 和激素治疗;HBOT 非联合组(50 侧),仅接受激素治疗。根据听力损失程度比较两组的恢复率。评估血液样本,根据严重程度计算并比较炎症标志物,如中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)。评估炎症标志物对预测恢复率的有用性,并评估临界值。
HBOT 联合组的总体恢复率高于 HBOT 非联合组,尤其是在重度病例中。然而,基于各种炎症标志物,听力损失严重程度无显著差异。NLR 和 PLR 对接受 HBOT 联合治疗的患者的疗效预测有用。当 NLR 和 PLR 的截断值分别设定为 2.43 和 146.67 时,我们观察到较低的值与更好的恢复率相关。
对于重度病例和早期血流障碍,使用 HBOT 联合治疗具有较好的疗效,此时 NLR 和 PLR 较低,炎症反应较轻。在确定治疗方案时,不仅要考虑听力损失的严重程度,还要根据临界值评估和检查 NLR 和 PLR。