Ani İşitme Kaybı Olan Hastalarda Prognoz Üzerine Etkili Faktörlerin İncelenmesi

Abstract

Ev aluation of Factors Effective on Prognosis in Patients with Sudden Hearing Loss Sudden sensorioneural hearing loss is one of the important illnesses that has to be managed immediately, however consensus about its treatment is not present. At its pathophysiology, causes like viral infection, vascular factors, labirinth membrane rupture and autoimmunity are thought to be responsible. Although macromolecules like steroids, vasodilatator drugs, plasma volume expanders and urografin are used at treatment, many new treatment modalities are tried. This study was performed in 37 patients with the diagnosis of sudden hearing loss admitted to Ondokuz Mayis University Faculty of Medicine Otorhinolaryngology Department between May 2003 and April 2006. Steroid (1 mg/kg oral), urografin (10 ml i.v. at first day, then 5 ml i.v.), reomakrodeks (500 ml i.v. infusion for 8 hours) and piracetam (2x6 g i.v. for 5 days) were given to all patients. Criteria determined by 'Sudden Deafness Research Team of the Japanese Ministry of Health and Welfare' were used in the evaluation of treatment results. When the treatment results were evaluated, it was seen that prognosis was bad in patients with total hearing loss and hearing loss involving low frequencies had a better prognosis. In the presence of tinnitus as a vestibulocochlear symptom, prognosis was better. Ani sensorinöral işitme kaybı acil müdahale edilmesi gereken, ancak henüz tanı ve tedavisinde fikir birliğine varılamamış, önemli hastalıklardan biridir. Patofizyolojide viral enfeksiyon, vasküler patolojiler, labirent membran rüptürü, otoimmünite gibi nedenler sorumlu tutulmaktadır. Tedavide steroidler, vazadilatör ilaçlar, plazma volüm genişleticileri, ürografin gibi makromoleküller kullanılmakla birlikte gün geçtikçe birçok yeni tedavi modaliteleri denenmektedir. Bu çalışma Mayıs 2003-Nisan 2006 tarihleri arasında Ondokuz Mayıs Üniversitesi Tıp Fakültesi Kulak Burun Boğaz kliniğine başvuran ve ani işitme kaybı tanısı ile tedavi edilen 37 hastada yapıldı. Tüm hastalara steroid (1 mg/kg, oral), ürografin (ilk gün 10cc, dört gün 5 cc iv), reomakrodeks (500 cc/8 saat iv infüzyon) ve pirasetam (2x6 gr iv beş gün) verildi. Tedavi sonuçlarının değerlendirilmesinde 'Sudden Deafness Research Team of the Japanese Ministry of Health and Welfar' tarafından belirlenen kriterler kullanıldı. Tedavi sonuçları değerlendirildiğinde total işitme kayıplı hastalarda prognozun kötü, alçak frekansları tutan işitme kayıplı hastalarda ve vestibülokoklear semptomlardan tinnitus varlığında prognozun daha iyi olduğu görülmüştür.

Keywords

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References

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