Dergiler / Kulak Burun Boğaz İhtisas Dergisi / 2015 / Cilt: 25 - Sayı: 2
Efficacy of multimodality approach to sudden hearing loss
- Sayfa
- 77–81
- DOI
- —
Özet
Amaç: Bu çalışmada ani işitme kaybının (AİK) tedavisinde sistemik steroid ve hiperbarik oksijene (HBO) ilave olarak intratimpanik steroidin (ITS) etkinliği araştırıldı. Hastalar ve Yöntemler: Ocak 2008 - Ekim 2011 tarihleri arasında AİK tanısı konulan 58 hasta çalışmaya dahil edildi. Sistemik steroid ve HBO tedavisi uygulanan 20 hasta (11 erkek, 9 kadın; ort. yaş 45.3±21 yıl; dağılım 24-66 yıl) grup 1i oluştururken; sistemik steroid ve HBO tedavisine ek olarak ITS tedavisi uygulanan 38 hasta (19 erkek, 19 kadın; ort. yaş 41.6±16 yıl; dağılım 25-61 yıl) grup 2yi oluşturdu. Bulgular: Tedavi sonrası iyileşme oranları, Siegel kriterlerine göre saf ses ortalamalarında her iki grup arasında istatistiksel olarak anlamlı bulundu (p 0.05). Ancak 90 dB üzeri derin işitme kayıplarında güçlü bir istasitiksel fark vardı (p<0.05). Grup 1de derin işitme kaybı olan altı hastanın hiçbiri (%0) tedaviden yarar görmezken, tedaviye ITS eklenen grup 2de derin işitme kaybı olan 12 hastanın altısında (%50) başarı sağlandı (p<0.05). Sonuç: İntratimpanik steroidin sistemik steroid ve HBO tedavisine ilavesi, AİK olan hastalarda daha iyi sonuçlar verebilir. Ancak, ITS enjeksiyonu derin AİK olan hastalar için yararlı görünmektedir.
Abstract
Objectives: This study aims to investigate whether addition of intratympanic steroid (ITS) to systemic steroid and hyperbaric oxygen (HBO) is effective in the treatment of sudden hearing loss (SHL). Patients and Methods: Between January 2008 and October 2011, 58 patients diagnosed with SHL were enrolled in the study. Twenty patients (11 males, 9 females; mean age 45.3±21 years; range 24 to 66 years) who received systemic steroid and HBO composed group 1, while 38 patients (19 males, 19 females; mean age 41.6±16 years; range 25 to 61 years) who received ITS in addition to systemic steroid and HBO composed group 2. Results: Post-treatment hearing improvement was statistically significant in both groups in terms of the mean pure tone according to the Siegels criteria (p<0.05). Treatment was successful at 55% of patients in group 1 and 63% in group 2. Despite increased success rate with the addition of ITS, it did not indicate statistical significance (p>0.05). However, there was a strong statistically significant difference in terms of profound hearing loss over 90 dB (p<0.05). None of six patients (0%) with profound hearing loss in group 1 benefited treatment, while addition of ITS to the treatment yielded success in six of 12 patients with profound hearing loss (50%) in group 2 (p<0.05). Conclusion: Addition of ITS to systemic steroid and HBO treatment may yield better results in patients with SHL. However, ITS injection seems beneficial for patients with profound SHL.