Ani İşitme Kaybı Olan Hastalarda Prognoz Üzerine Etkili Faktörlerin İncelenmesi

Year 2006, Volume: 23 Issue: 4, 120 - 124, 30.12.2009

M. Koyuncu Y. Tanyeri T. Şeşen R. Ünal A. Tekat S. Atmaca S. Çivici

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

-

References

• Suzuki H, Furukawa M, Kumagaı M, et al. Defibrinogenation therapy for ıdıopathıc sudden s e nsorineural hearing loss in comparasion with high dose steroid therapy. Acta Otolaryngol 2003: 46–50. 2. Saeki N, Kitahara M. Assessment of prognosis in s u d d e n deafness. Acta Otolaryngol (Stockh) 1994: Suppl. 510: 56–61.
• Byl FM. Sudden hearing loss: Eight year’s experience and suggested prognostic table. Laryngoscope 1984; 94: 647–661.
• Wilkins SA Jr, Mattox DE, Lyles A. Evaluation of a ‘Shoutgun’ regimen for sudden hearing loss. Otolaryngol Head Neck Surg. 1987; 97: 474–480.
• Papparella MM, Goycoolea MV, Meyerhoff WL. Ann Otol Rhinol Laryngol Suppl 1980; 89 (3Ptz): 249–253. 6. Oga sawara H, Morimoto K, Ishii K, et al. A statistical analysis of sudden deafness. J Oto-Rhino- Laryngological Soc Japan 1993; 96: 914–921.
• Ünal M, Katırcıoğlu OS, Karatay MC. Ani iflitme kaybı. Çukurova Üniv.Tıp Fak. Arfliv Kaynak Tarama Dergisi 1998; 7: 112–25
• Aydın S, Aydın E, Coflkuner T, ve ark. Ani iflitme kayıplarının değerlendirilmesi. Türk ORL ve Bafl Boyun Cerrahisi Derneği XXIII. Ulusal Kongresi, Antalya, Özet Kitabı.
• Myake H, Yanagita N. Therapy of sudden deafness. Acta Otolaryngol (Stockh) 1988; Suppl. 456: 27–30.
• Kallinen J, Laippala P, Laurikainen E. Sudden deafness: A comparison of anticoagulant therapy and carbogen inhalation therapy.Ann Otol Rhinol Laryngol 1997; 106: 22–26
• Moskowitz D, Lee KJ, Smith H. Steroid use in i d i o p a t h i c sudden sensorineural hearing loss. Laryngoscope 1984; 94: 664–666
• Nakashima T, Yanagita N. Outcome of sudden d e a f n e s s with and without vertigo. Laryngoscope 1993; 103:1145–1149
• Shiraishi T, Kubo T, Okumura S. Hearing recovery i n sudden deafness patients using a modified d e f i b r i n o g e n a t i o n therapy. Acta Otolaryngol (Stockh) 1993, Suppl. 501: 46–50.
• Ushisako Y, Morimitsu T. Studies on amidotrizoate therapy in sudden deafness (1978–1987) Acta Otolaryngol 1988; Suppl. 546: 37–42.
• Shaia FT, Sheehy JL. Sudden sensorineural hearing impairment: A report of 1220 cases. Laryngoscope 1976; 86: 389–398.
• Laird N, Wilson WR. Predicting recovery from i d i o p a t h i c suddenhearing loss. Am J Otolaryngol 1983; 4: 161–64
• Booth JB. Sudden and fluctuant sensorineural hearing loss. In: Booth JB (ed.) Otology Vol 3,Oxford, Scott Brown’s Otolaryngology, ButterwortHeineman Ltd.; Chapter 17, 1997.