Efficacy of intratympanic steroid administration on idiopathic sudden sensorineural hearing loss in comparison with hyperbaric oxygen therapy

被引:40
作者
Suzuki, Hideaki [1 ]
Hashida, Koichi [1 ]
Khac-Hung Nguyen [1 ]
Hohchi, Nobusuke [1 ]
Katoh, Akiko [1 ]
Koizumi, Hiroki [1 ]
Ohbuchi, Toyoaki [1 ]
机构
[1] Univ Occupat & Environm Hlth, Sch Med, Dept Otorhinolaryngol, Yahatanishi Ku, Kitakyushu, Fukuoka 8078555, Japan
关键词
Idiopathic sudden sensorineural hearing loss; intratympanic steroid administration; hyperbaric oxygen therapy; hearing outcome; Level of Evidence: 2b; DEXAMETHASONE; DEAFNESS;
D O I
10.1002/lary.23245
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives/Hypothesis: The efficacy of intratympanic steroid administration was examined in comparison with hyperbaric oxygen (HBO) therapy in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design: Retrospective study. Methods: Two hundred seventy-six consecutive patients with ISSNHL (average hearing levels at 250, 500, 1,000, 2,000, and 4,000 Hz >= 40 dB; time from onset to treatment <= 30 days) were enrolled. All the patients were given intravenous hydrocortisone (400 mg/day) followed by tapered doses. In addition, 174 patients underwent HBO therapy (HBO group), and 102 patients received intratympanic dexamethasone injection (IT group). The hearing outcomes were evaluated by six indices; the cure rate, marked-recovery rate (percent of patients with hearing gains >= 30 dB), recovery rate (percent of patients with hearing gains >= 10 dB), hearing gain, hearing level after treatment, and hearing improvement rate compared to the unaffected contralateral ear. Results: There was no significant difference in the cure rate, marked-recovery rate, hearing gain, hearing level after treatment, or hearing improvement rate between the two groups; however, the recovery rate was significantly higher in the IT group than in the HBO group (79.4% vs. 68.4%; P = .048). Multiple logistic regression analysis also showed that patients in the IT group were significantly more likely to recover than those in the HBO group (odds ratio: 2.045; 95% confidence interval: 1.097-3.812; P = .024). Conclusions: Systemic plus intratympanic steroid administration is more effective than systemic steroids plus HBO therapy, and can be a useful first-choice treatment for ISSNHL.
引用
收藏
页码:1154 / 1157
页数:4
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