高压氧治疗特发性突发性感音神经性听力损失：一项关于10次与超过10次治疗的队列研究。
Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss: a cohort study of 10 versus more than 10 treatments.
作者信息
Laupland Brenda R, Laupland Kevin B, Thistlethwaite Kenneth
机构信息
Hyperbaric Medicine Unit, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Corresponding author: Dr Brenda R Laupland, Hyperbaric Medicine Unit, Ned Hanlon Building, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD 4006, Brisbane, Australia, ORCiD: 0009-0005-4883-1932,
出版信息
Diving Hyperb Med. 2024 Dec 20;54(4):275-280. doi: 10.28920/dhm54.4.275-280.
INTRODUCTION
Current treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) includes a combination of corticosteroids and hyperbaric oxygen therapy (HBOT) without established dose. The objective of this study was to investigate whether > 10 HBOT treatments offers improved outcome over 10 treatments.
METHODS
A retrospective chart review was performed of patients treated with HBOT for ISSNHL between 2013 and 2022 at the Royal Brisbane and Women's Hospital. Pure tone average results from 500, 1,000, 2,000, 4,000 hertz (PTA4) were obtained pre-treatment, after treatment 10, and six weeks post-treatment.
RESULTS
There were 479 patients treated for ISSNHL: 144 having audiograms six weeks post-treatment, 140 of whom also had an audiogram after treatment 10. At six weeks post treatment 22% (32/144) had normal hearing (PTA4 < 25 dB), and 69% (99/144) had a PTA4 gain ≥ 10 dB. At the treatment 10 audiogram, 83/140 (59%) were improved. From these, 5/21 (24%) with 10 treatments and 14/57 (25%) with > 10 treatments had a further PTA4 gain of ≥ 10 dB occurring after treatment 10. For those 57/140 (41%) not improved at treatment 10, 7/26 (27%) with 10 treatments and 12/31 (39%) with > 10 treatments were improved at six weeks post-treatment with 5/7 (71%) and 8/12 (67%) of the 10 and > 10 groups respectively having ≥ 10 dB gain in PTA4 occurring after treatment 10. Overall, there was no significant difference in mean (SD) hearing gain from treatment 10 to six weeks post treatment between the 10 treatments and > 10 treatments groups: 4.73 (8.90) versus 5.93 (11.25) dB, P = 0.53.
CONCLUSIONS
In conjunction with steroids, 10 treatments of hyperbaric oxygen therapy appear to offer equivalent benefit to > 10 treatments. Similar improvements in PTA4 and hearing recovery occur after 10 HBOT treatments independent of ongoing HBOT. A prospective trial comparing 10 versus > 10 treatments for ISSNHL with outcome measured beyond treatment completion is warranted.
引言
目前特发性突发性感音神经性听力损失（ISSNHL）的治疗方法包括皮质类固醇和高压氧治疗（HBOT）的联合使用，但剂量尚未确定。本研究的目的是调查超过10次的HBOT治疗是否比10次治疗能带来更好的治疗效果。
方法
对2013年至2022年在皇家布里斯班妇女医院接受HBOT治疗的ISSNHL患者进行回顾性病历审查。在治疗前、治疗10次后以及治疗后六周获取500、1000、2000、4000赫兹的纯音平均结果（PTA4）。
结果
共有479例患者接受了ISSNHL治疗：144例在治疗后六周进行了听力图检查，其中140例在治疗10次后也进行了听力图检查。治疗后六周，22%（32/144）的患者听力正常（PTA4<25dB），69%（99/144）的患者PTA4增益≥10dB。在治疗10次时的听力图检查中，140例中有83例（59%）有改善。其中，接受10次治疗的21例中有5例（24%），接受超过10次治疗的57例中有14例（25%）在治疗10次后PTA4进一步增益≥10dB。对于治疗10次时未改善的57/140例（41%）患者，接受10次治疗的26例中有7例（27%），接受超过10次治疗的31例中有12例（39%）在治疗后六周有所改善，10次治疗组和超过10次治疗组分别有5/7（71%）和8/12（67%）的患者在治疗10次后PTA4增益≥10dB。总体而言，10次治疗组和超过10次治疗组从治疗10次到治疗后六周的平均（标准差）听力增益无显著差异：4.73（8.90）dB对5.93（11.25）dB，P=0.53。
结论
与类固醇联合使用时，10次高压氧治疗似乎与超过10次治疗具有同等益处。10次HBOT治疗后，无论是否继续进行HBOT，PTA4和听力恢复都有类似改善。有必要进行一项前瞻性试验，比较10次和超过10次治疗对ISSNHL的效果，并在治疗完成后测量结果。
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