Gutkovich Yoni E, Manheim Maayan, Veler Rina, Geva Amit, Tal Dror
Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel.
Department of Otolaryngology - Head and Neck Surgery, HaEmek Medical Centre, Afula, Israel.
Eur Arch Otorhinolaryngol. 2025 Jan 25. doi: 10.1007/s00405-025-09246-7.
Acute acoustic trauma (AAT) is a sudden sensorineural hearing loss (SNHL) due to exposure to high intensity impulse noise. There are no acceptable treatment guidelines, although several studies showed steroids could be effective in restoring hearing levels. A recent report suggested that steroids combined with hyperbaric oxygen therapy (HBOT) are a superior regiment for AAT. The purpose of the current study is to investigate the effectiveness of steroids and HBOT for AAT treatment.
the medical records 90 patients (118 ears) afflicted with AAT and treated with steroids and HBOT were retrospectively reviewed. Inclusion criteria were sensorineural hearing loss of at least 30 dB at the high frequency range (> 3,000 Hz) following exposure to intense sound. Patients who started treatment within 7 days were classified as "Early treatment" group whereas patients who started treatment ≥ 8 days after AAT were classified as "Late treatment".
The high frequency (3-8 kHz) Pure Tone Average (hPTA) of the entire study population (n = 118) was 40.26 ± 15.42 dB pretreatment vs. 24.99 ± 15.83 dB post treatment (Wilcoxon matched-pairs test, P < 0.0001). Pre-treatment hPTA was not statistically different between early and late study groups, 39.87 ± 16.00 vs. 40.86 ± 14.35 dB in the early vs. late group, respectively (ANOVA, F[3,232] = 22.574, P > 0.05). The post-treatment hPTA on the other hand, was significantly lower in the early vs. late treatment groups (21.93 ± 15.38 vs.31.19 ± 15.09 dB, respectively; ANOVA, F[3,232] = 22.574, P < 0.05).
Combination treatment with corticosteroids and HBOT is highly beneficial in improving hearing outcomes following AAT, when initiated within 7 days. This study was retrospectively registered on July 19th 2020 and assigned the identifier number NCT04482998.
急性声创伤（AAT）是由于暴露于高强度脉冲噪声而导致的突发性感音神经性听力损失（SNHL）。尽管多项研究表明类固醇可能对恢复听力水平有效，但目前尚无公认的治疗指南。最近一份报告表明，类固醇联合高压氧治疗（HBOT）是治疗AAT的更优方案。本研究的目的是探讨类固醇和HBOT治疗AAT的有效性。
回顾性分析90例（118耳）接受类固醇和HBOT治疗的AAT患者的病历。纳入标准为暴露于高强度声音后高频范围（>3000Hz）感音神经性听力损失至少30dB。在7天内开始治疗的患者被归类为“早期治疗”组，而在AAT发生后≥8天开始治疗的患者被归类为“晚期治疗”组。
整个研究人群（n=118）治疗前高频（3-8kHz）纯音平均听阈（hPTA）为40.26±15.42dB，治疗后为24.99±15.83dB（Wilcoxon配对检验，P< 0.0001）。早期和晚期研究组治疗前hPTA无统计学差异，早期组和晚期组分别为39.87±16.00dB和40.86±14.35dB（方差分析，F[3,232]=22.574，P> 0.05）。另一方面，早期治疗组治疗后的hPTA显著低于晚期治疗组（分别为21.93±15.38dB和31.19±15.09dB；方差分析，F[3,232]=22.574，P< 0.05）。
在7天内开始使用皮质类固醇和HBOT联合治疗对改善AAT后的听力结果非常有益。本研究于2020年7月19日进行回顾性注册，注册号为NCT04482998。
