Combined treatment supported by piracetam and/or acyclovir in idiopathic sudden sensorineural hearing loss: experience with 81 cases

Year 2009, Volume: 19 Issue: 1, 22 - 27, 01.02.2009

Süleyman Emre Karakurt Mehmet Doğan Özkul İbrahim Çukurova Erhan Demirhan Orhan Gazi Yiğitbaşı

Abstract

Objectives: To investigate the efficiency of piracetam and acyclovir in treating sudden hearing loss. Patients and Methods: Eightyone patients 44 males, 37 females; mean age 40.4 year; range 18 to 72 years who had treatment between January 2002 and December 2006 with diagnosis of idiopathic sudden hearing loss were evaluated retrospectively. These patients were divided into four groups according to the treatment they received. The patients who had combined treatment constituted the first group; those who had combined treatment and piracetam the second; those who had combined treatment and acyclovir the third; those who had combined treatment, acyclovir, and piracetam the fourth group. Results: For the four treatment groups, in the pre-and post-treatment 10th day evaluation of the treatment efficiency made by calculation of the hearing thresholds in 250-8000 Hz frequencies, no significant difference between the groups was determined p>0.05 . Conclusion: No additional benefit was obtained with acyclovir and piracetam in treatment.

Keywords

Acyclovir, piracetam, sudden hearing loss

Ani işitme kayıplarında pirasetam ve/veya asiklovir eklenerek yapılan kombine tedavi: 81 olguluk deneyim

Abstract

Amaç: Pirasetam ve asiklovirin ani işitme kaybındaki tedavi edici etkinliği araştırıldı.Hastalar ve Yöntemler: Ocak 2002-Aralık 2006 tarihleri arasında idiyopatik ani işitme kaybı tanısıyla tedavi edilen 81 hasta 44 erkek, 37 kadın; ort. yaş 40.4 yıl; dağılım 18-72 yıl geriye dönük olarak incelendi. Hastalar aldıkları tedaviye göre dört gruba ayrıldı. Birinci grubu kombine tedavi alan hastalar, ikinci grubu kombine tedavi ve pirasetam alan hastalar, üçüncü grubu kombine tedavi ve asiklovir alan hastalar, dördüncü grubu ise kombine tedavi, asiklovir ve pirasetam alan hastalar oluşturdu.Bulgular: Dört tedavi grubu için, tedavi öncesi ve sonrası 10. günde 250-8000 Hz frekanslarında işitme eşiklerinin farkı hesaplanarak tedavi etkinliği değerlendirildi, gruplar arasında anlamlı fark saptanmadı p>0.05 .Sonuç: Asiklovir ve pirasetam ile tedavide ek bir fayda elde edilmediği gözlendi

Keywords

Asiklovir, pirasetam, ani işitme kaybı

References

• Arts H. Sensorineural hearing loss: evaluation and management in adults. In: Cummings CW, edi- tor. Otolaryngology Head & Neck Surgery. 4th ed. Philadelphia: Elsevier; 2005. p. 3535-55.
• Koç C. Sensörinöral işitme kayıpları. In: Gürsel B, Kılıç R, editörler. Kulak Burun Boğaz Hastalıkları ve Baş Boyun Cerrahisi. Ankara: Güneş Kitabevi; 2004. s. 279-300.
• Coşkuner T, Akbulut S, Berk D, Ünver Ş. Ani işitme kaybı olgularında steroid, asiklovir ve steroid ile bir- likte hiperbarik oksijen tedavisi sonuçlarının karşılaş- tırılması. Türk Otolarengoloji Arşivi 2003;41:11-19.
• Gersdorff M, Franceschi D. Value of piracetam in the treatment of sudden idiopathic deafness. Preliminary report. Ann Otolaryngol Chir Cervicofac 1986;103:283-5. [Abstract]
• Çelik O. Erişkinlerde sensörinöral işitme kayıpları. In: Koyuncu M, editör. Kulak Burun Boğaz Hastalıkları ve Baş Boyun Cerrahisi. İzmir: Asya Tıp Kitabevi; 2007. s. 77-94.
• Haberkamp TJ, Tanyeri HM. Management of idio- pathic sudden sensorineural hearing loss. Am J Otol 1999;20:587-92.
• Wilkins SA Jr, Mattox DE, Lyles A. Evaluation of a “shot- gun” regimen for sudden hearing loss. Otolaryngol Head Neck Surg 1987;97:474-80.
• García Callejo FJ, Ramírez Sabio JB, Conill Tobías N, Sebastian Gil E, Orts Alborch MH, Marco Algarra J. Immunomediation or hyperviscosity in rapidly pro- gressive sensorineural hearing loss. A therapeutic approach. Acta Otorrinolaringol Esp 2006;57:204-9.
• García Callejo FJ, Velert Vila MM, Morant Ventura A, Orts Alborch MH, Marco Algarra J, Blay Galaud L. Pathophysiological rationale for the use of pirac- etam in sudden deafness. Acta Otorrinolaringol Esp 2000;51:319-26. [Abstract]
• Solanellas Soler J, Esteban Ortega F, Soldado Patiño L, Jiménez Morales JM. Sudden hearing loss. Treatment with piracetam. Acta Otorrinolaringol Esp 1997;48:21-5. [Abstract]
• Gutmann R, Mees K. Piracetam infusions in acute tin- nitus and sudden deafness. Fortschr Med 1995;113:288- 90. [Abstract]
• Samim E, Kilic R, Ozdek A, Gocmen H, Eryilmaz A, Unlu I. Combined treatment of sudden sensorineural hearing loss with steroid, dextran and piracetam: experience with 68 cases. Eur Arch Otorhinolaryngol 2004;261:187-90.
• Stokroos RJ, Albers FW, Schirm J. Therapy of idiopathic sudden sensorineural hearing loss: antiviral treatment of experimental herpes simplex virus infection of the inner ear. Ann Otol Rhinol Laryngol 1999;108:423-8.
• Stokroos RJ, Albers FW, Tenvergert EM. Antiviral treatment of idiopathic sudden sensorineural hearing loss: a prospective, randomized, double-blind clinical trial. Acta Otolaryngol 1998;118:488-95.
• Tucci DL, Farmer JC Jr, Kitch RD, Witsell DL. Treatment of sudden sensorineural hearing loss with systemic steroids and valacyclovir. Otol Neurotol 2002;23:301-8.
• Uri N, Doweck I, Cohen-Kerem R, Greenberg E. Acyclovir in the treatment of idiopathic sudden sen- sorineural hearing loss. Otolaryngol Head Neck Surg 2003;128:544-9.
• Conlin AE, Parnes LS. Treatment of sudden sen- sorineural hearing loss: II. A Meta-analysis. Arch Otolaryngol Head Neck Surg 2007;133:582-6.
• Zadeh MH, Storper IS, Spitzer JB. Diagnosis and treat- ment of sudden-onset sensorineural hearing loss: a study of 51 patients. Otolaryngol Head Neck Surg 2003;128:92-8.
• Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463-80.
• Nedzelski JM, Dufour JJ. Acoustic neurinomas pre- senting as sudden deafness. ORL J Otorhinolaryngol Relat Spec 1975;37:271-9.
• Finger RP, Gostian AO. Idiopathic sudden hearing loss: contradictory clinical evidence, placebo effects and high spontaneous recovery rate--where do we stand in assessing treatment outcomes? Acta Otolaryngol 2006;126:1124-7.
• Cura O, Günhan Ö, Bilgen V, Özkul D, Kirazlı T. Ani sağırlıkta uyguladığımız tedavi ve sonuçlar. Türk Otolarengoloji Arşivi 1985;23:86-91.