Comparative efficacies of intratympanic steroid administration and classic therapy in the management of idiopathic sudden sensorineural hearing loss

Year 2013, Volume: 3 Issue: 2, 51 - 55, 01.06.2013

Murat Gümüşsoy İlker Burak Arslan İbrahim Çukurova

https://doi.org/10.2399/jmu.2013002002

Abstract

Objective: Sudden hearing loss is a sensorineural hearing loss with an unknown etiology at ≥30 dB which appears in 3 days or within a shorter period of time and obstructs three successive frequencies. Our objective in this study is to assess the effectiveness of the combination of classic therapy and intratympanic steroid treatment in the management of idiopathic sudden sensorineural hearing loss. Methods: One hundred and forty patients diagnosed with idiopathic sudden sensorineural hearing loss in our clinics between February 2010 and June 2012 were separated into 2 groups. Seventy-six patients [37 women (48.68%) and 39 men (51.32%)] with a mean age of 45.1±14.16 years managed with a combination of classic sudden hearing loss and intratympanic steroid treatment (Group 1) and 64 patients [34 women (53.18%) and 30 men (46.82%)] with a mean age of 47.6±17.74 years managed with only classic sudden hearing loss treatment (Group 2) were included in the study. One month after the study, pure-tone averages and speech discrimination scores of the patients were compared with those obtained 1 month before the treatment. Results: Pure-tone average of the intratympanic-steroid treatment group was found to be 68.28 dB before the treatment where in the other group it was 67.21 dB without any statistically significant difference between groups. When followed-up 1 month after the therapy, pure-tone average was found to be 33.52 dB in the intratympanic steroid treatment group and 44.46 dB in the classic therapy group with a statistically significant intergroup difference. Gain was up to 34.76 dB in the intratympanic steroid treatment group whereas in the classic therapy group, the difference was 22.75 dB which was found to be statistically significant (p

Keywords

Sudden hearing loss, sensorineural hearing loss, intratympanic steroid

İdiopatik ani işitme kaybında intratimpanik steroid uygulaması ile klasik tedavi etkinliğinin karşılaştırılması

Abstract

Amaç: Ani işitme kaybı, nedeni bilinmeyen, üç gün içerisinde veya
daha kısa zamanda aniden ortaya çıkan, birbirini takip eden üç frekansı
tutan, 30 dB ve üzerindeki sinirsel tipte işitme kaybıdır. Bu çalışmadaki
amacımız, intratimpanik steroid tedavisi ile birlikte klasik tedavi
birlikteliğinin idiopatik ani işitme kaybı tedavisinde etkinliğini değerlendirmektir.
Yöntem: Şubat 2010 – Haziran 2012 tarihleri arasında kliniğimizde
idiopatik ani işitme kaybı tanısı alan 140 hasta çalışmaya alınarak iki
gruba ayrıldı. İntratimpanik steroid tedavisi ve klasik ani işitme kaybı
tedavisi alan 76 hasta [37’si kadın (%48.68), 39’u erkek (%51.32); yaş
ortalaması 45.1±14.16] ile sadece klasik tedavi kombinasyonu uygulanan
64 hasta [34’ü kadın (%53.18), 30’u erkek (%46.82); yaş ortalaması
47.6±17.74] çalışmaya dahil edildi. Tedaviden 1 ay sonra hastaların
saf ses ortalamaları ve konuşmayı ayırt etme skoru, tedavi öncesindeki
saf ses ortalamaları ve konuşmayı ayırt etme skoru ile karşılaştırıldı.
Bulgular: Tedavi öncesi saf ses ortalaması, intratimpanik steroid tedavi
grubunda 68.28 dB, diğer grupta 67.21 dB olarak bulundu ve istatistiksel
olarak aralarında fark yoktu. Tedavi sonrasında 1. ay kontrolünde
saf ses ortalaması, intratimpanik steroid tedavi grubunda
33.52 dB, klasik tedavi grubunda 44.46 dB olarak bulundu ve istatistiksel
olarak aralarındaki fark anlamlıydı. İntratimpanik steroid tedavi
grubunda kazanç 34.76 dB’e yükselirken, klasik tedavi grubunda
fark 22.75 dB olarak ölçüldü ve bu sonuç istatistiksel olarak anlamlı
bulundu (p < 0.05).
Sonuç: İdiopatik ani işitme kaybı tedavisinde, klasik ani işitme kaybı
tedavi protokolü ile kombine edilen intratimpanik steriod uygulaması,
işitme kazancı yönünden sadece klasik kombine tedavi alan hastalara
kıyasla anlamlı sonuçlar vermektedir.

Keywords

Ani işitme kaybı, sensorinöral işitme kaybı, intratimpanik steroid

References

• Shikowitz MJ. Sudden sensorineural hearing loss. Med Clin North Am 1991;75:1239-50.
• Byl FJ. Sudden hearing loss: eight years’ experience and suggest- ed prognostic table. Laryngoscope 1984;94:647-61.
• Haberkamp TJ, Tanyeri HM. Management of idiopathic sudden sensorineural hearing loss. Am J Otol 1999;20:587-95.
• Moskowitz D, Lee KJ, Smith HW. Steroid use in idiopathic sud- den sensorineural hearing loss. Laryngoscope 1984;94:664-6.
• Mattox DE, Simmons FB. Natural history of sudden sen- sorineural hearing loss. Ann Otol Rhinol Laryngol 1986:463-80.
• Rauch SD. Intratympanic steroids for sensorineural hearing loss. Otolaryngol Clin North Am 2004;37:1061-74.
• Barany R. Die Beinflussung des Ohrensausens durch intravenöse Lokalanaestetica. Acta Otolaryngol 1935;23:201-3.
• Schuknecht HF. Ablation therapy in the management of Meniere’s disease. Acta Otolaryngol 1957;132:1-42.
• Sakata E, Itoh A, Ohtsu K, et al. Pathology and treatment of cochlear tinnitus by blocking with %4 lidocaine and Decadron infusion. Practica Otologica (Kyoto) 1982;75:2525-35.
• Zadeh MH, Storper IS, Spitzer JB. Diagnosis and treatment of sudden-onset sensorineural hearing loss: a study of 51 patients. Otolaryngol Head Neck Surg 2003;128:92-8.
• Leong AC, Fairley JW, Padgham ND. Sudden hearing loss. Clin Otolaryngol 2007;32:391-4.
• Conlin AE, Parnes LS. Treatment of sudden sensorineural hear- ing loss: I. A systematic review. Arch Otolaryngol Head Neck Surg 2007;133:573-81.
• Wilkins SA Jr, Mattox DE, Lyles A. Evaluation of a shotgun reg- iment for sudden hearing loss. Otolaryngol Head Neck Surg 1987;5:74-80.
• Chandrasekhar SS. Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otol Neurotol 2001;22:18-23.
• Alexiou C, Arnold W, Fauser C, et al. Sudden sensorineural hear- ing loss:Does application of glucocorticoids make sense? Arch Otolaryngol Head Neck Surg 2001;127:253-8.
• Ho HG, Lin HC, Shu MT, Yang CC, Tsai HT. Effectiveness of intratympanic dexamethasone injection in sudden-deafness patients as salvage treatment. Laryngoscope 2004;114:1184-9.
• Gianoli GJ, Li JC. Transtympanic steroids for treatment of sud- den hearing loss. Otolaryngol Head Neck Surg 2001;125:142-6.
• Kopke RD, Hoffer ME, Wester D, O’Leary MJ, Jackson RL. Targeted topical steroid therapy in sudden sensorineural hearing loss. Otol Neurotol 2001; 22:475-9.
• Itoh A, Sakata E. Treatment of vestibular disorders. Acta Otolarygol 1991;481:617-23.
• Nomura Y. Otological significance of the round window. Adv Otorhinolaryngol 1984;33:1-162.
• Parnes LS, Sun AH, Freeman DJ. Corticosteroids pharmacoki- netics in the inner ear fluids: an animal study followed by clini- cal application. Laryngoscope 1999;109:1-17.
• Herr BD, Marzo SJ. Intratympanic steroid perfusion for refrac- tory sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2005;132:527-31.
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• Please cite this article as: Gümüflsoy M, Arslan ‹B, Çukurova ‹. Comparative efficacies of intratympanic steroid administration and classic therapy in
• the management of idiopathic sudden sensorineural hearing loss. J Med Updates 2013;3(2):51-55.