Prognostic impact of salvage treatment on hearing recovery in patients with sudden sensorineural hearing loss refractory to systemic corticosteroids: A retrospective observational study

被引:23
作者
Nakagawa, Takayuki [1 ,7 ]
Yamamoto, Michio [2 ]
Kumakawa, Kozo [3 ]
Usami, Shin-ichi [4 ]
Hato, Naohito [5 ]
Tabuchi, Keiji [6 ]
Takahashi, Mariko [8 ]
Fujiwara, Keizo [9 ]
Sasaki, Akira [10 ]
Komune, Shizuo [11 ]
Yamamoto, Norio [1 ]
Hiraumi, Harukazu [1 ]
Sakamoto, Tatsunori [1 ]
Shimizu, Akira [12 ]
Ito, Juichi [1 ]
机构
[1] Kyoto Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Sakyo Ku, Kawaharacho 54, Kyoto 6068507, Japan
[2] Kyoto Univ Hosp, Inst Adv Clin & Translat Sci, Dept Data Sci, Kyoto 6068507, Japan
[3] Toranomon Gen Hosp, Dept Otolaryngol, Okinaka Mem Inst Med Res, Tokyo 1058470, Japan
[4] Shinshu Univ, Sch Med, Dept Otorhinolatyngol, Matsumoto, Nagano 3908621, Japan
[5] Ehime Univ, Grad Sch Med, Dept Otolaryngol, Matsuyama, Ehime 7910295, Japan
[6] Univ Tsukuba, Grad Sch Comprehens Human Sci, Dept Otolatyngol, Tsukuba, Ibaraki 3058575, Japan
[7] Nagoya City Univ, Grad Sch Med Sci, Dept Otolaryngol Head & Neck Surg, Nagoya, Aichi 4768601, Japan
[8] Sch Med, Nagoya, Aichi 4768601, Japan
[9] Gen Hosp, Dept Otolaryngol, Kobe City Med Ctr, Kobe, Hyogo 6500047, Japan
[10] Hirosaki Univ, Grad Sch Med, Dept Otorhinolaryngol, Hirosaki, Aomori 0368562, Japan
[11] Kyushu Univ, Grad Sch Med Sci, Dept Otorhinolaryngol, Fukuoka 8128582, Japan
[12] Kyoto Univ Hosp, Inst Adv Clin & Translat Sci, Dept Expt Therapeut, Kyoto 6068507, Japan
基金
日本学术振兴会;
关键词
Sudden sensorineural hearing loss; Insulin-like growth factor 1; Drug delivery system; Multiple regression analysis; Local application; PLACEBO-CONTROLLED TRIAL; CLINICAL-TRIAL; TRIPLE-BLIND; THERAPY; HYDROGELS; DEAFNESS; INJURY; CELLS;
D O I
10.1016/j.anl.2015.12.004
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective: To determine the prognostic factors for hearing recovery in patients with sudden sensorineural hearing loss (SSHL) refractory to systemic corticosteroids following salvage treatment. Methods: This is a retrospective observational study at nine tertiary referral hospitals. A total of 120 patients with sudden deafness refractory to systemic corticosteroids were enrolled. The patients were randomly assigned to receive topical application of recombinant human IGF-1 or intratympanic injection of dexamethasone as salvage treatment. Multiple regression analysis was performed to identify determinants of hearing recovery using pure tone audiometry results at 8 weeks after treatment. Clinical predictors that were evaluated included age, sex, pretreatment hearing level, presence of vertiginous symptoms, days to study entry from symptom onset and salvage treatment assignment (IGF-1 vs. dexamethasone). Results: The linear regression model identified age (P = 0.001), pretreatment hearing level (P < 0.001), days to study entry from symptom onset (P = 0.011) and treatment assignment (P = 0.033) at 8 weeks after treatment as significant variables influencing the recovery of pure tone audiometry average thresholds. Younger age (<60 years), early initiation of salvage treatment and treatment with topical IGF-1 therapy had significant effects on hearing recovery. Conclusion: The results indicate that early initiation and choice of treatment modalities for salvage treatment may be important for the prognosis of patients with refractory SSHL. The positive effect of topical IGF-1 therapy on hearing recovery indicates its utility as salvage treatment. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:489 / 494
页数:6
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