Russolo M, Bianchi M
Clinica ORL, Universitã di Trieste.
Acta Otorhinolaryngol Ital. 1997 Oct;17(5):319-24.
A total of 27 patients affected by sudden idiopathic deafness (SID) and 3 with sudden idiopathic anacousia (SIA) were treated within 10 days of onset of the disorder. The treatment consisted of intramuscular or per os administration of corticosteriods for 10 days and the simultaneous administration of carbogene for 5 days. At the 5th day of corticosonic treatment, if audiometry did not reveal complete recovery, the treatment was associated for 7 days with Destrane 500 ml. The cases included neurosensorial deafness of 30 dB or more over at least 3 adjacent frequencies and arising over a 12 hour period. Soft cord deafness was not included in the study. The following variables were analyzed: 1) patient age; 2) extent of the hearing loss: average tone threshold for the frequencies of 500 -1000-2000 Hz equal to or better than 70 dB HL (group A); tone threshold ranging between 71 and 89 dB HL (group B), tone threshold ranging from 90 to 110 dB HL (group C), anacousia (group D); 3) audiometric curve; 4) presence or lack of vertigo. After treatment 25 subjects (83%) indicated a recovery ranging from good to complete. It is significant that among this 83% there were 12 subjects, 9 with profound deafness and 3 with anacousia. The therapeutic association adopted made it possible to achieve two-fold activity: anti-edemagene and hemorheological. The most highly implicated etiology for SID was viral causing not only neural but also endothelial damage and leading to acute microcirculatory insufficiency.
共有27例突发性特发性聋(SID)患者和3例突发性特发性听觉失聪(SIA)患者在疾病发作后10天内接受了治疗。治疗包括肌肉注射或口服皮质类固醇10天,并同时吸入含5%二氧化碳的氧气5天。在皮质类固醇治疗的第5天,如果听力测试未显示完全恢复,则将治疗与500毫升低分子右旋糖酐联合使用7天。纳入研究的病例包括至少3个相邻频率听力损失30分贝或更高且在12小时内发生的感音神经性聋。软性耳蜗性聋不包括在本研究中。分析了以下变量:1)患者年龄;2)听力损失程度:500-1000-2000赫兹频率的平均音调阈值等于或优于70分贝听力级(A组);音调阈值在71至89分贝听力级之间(B组),音调阈值在90至110分贝听力级之间(C组),听觉失聪(D组);3)听力图曲线;4)是否存在眩晕。治疗后,25名受试者(83%)显示出从良好到完全的恢复。值得注意的是,在这83%的受试者中,有12名受试者,9名重度耳聋患者和3名听觉失聪患者。所采用的联合治疗能够实现双重作用:抗水肿和血液流变学作用。SID最主要的病因是病毒感染,不仅导致神经损伤,还导致内皮损伤,进而导致急性微循环功能不全。