Çinko Tedavisi Ani İşitme Kaybında Etkili Olabilir mi?

Yıl 2021, Cilt: 43 Sayı: 6, 565 - 571, 24.09.2021

Erhan Arslan , Hasan Çanakcı

https://doi.org/10.20515/otd.936135

Öz

Ani işitme kaybı (AİK) tedavisinde hem bir anti-inflamatuvar hem de bir antioksidan olan çinkonun etkinliğini araştırmaktır. Bu çalışma etik kurul onayı alındıktan sonra retrospektif olarak üçüncü basamak sağlık kuruluşunda yapılmıştır. Çalışmaya 18- 65 yaş aralığında, AİK tedavisi için sistemik steroid ya da sistemik steroid ile birlikte çinko kullanılan hastalar dahil edilmiştir. Hastalar kullanılan tedavi çeşidine göre iki gruba ayrıldı. Tedavide sistemik steroid kullanılan hastalar Grup 1’e, sistemik steroide ilave olarak çinko kullanılan hastalar ise Grup 2’ye dahil edildi. Tedavi etkinliğini değerlendirmek için işitme geri dönüş yüzdesi, işitme kazancı ve Furuhashi kriterleri kullanıldı. Grup 1 ve Grup 2 tedavi etkinliği açısından karşılaştırıldı. Çalışmaya, dahil edilme kriterlerini sağlayan Grup 1 de 40, Grup 2 de 36 olmak üzere toplam 76 hasta dahil edilmiştir. İki grup demografik verileri (yaş, cinsiyet), işitme kaybı geçirilen kulağın tarafı, işitme kaybına vertigo ve tinnitusun eşlik edip etmemesi, hastaların mevcut sistemik hastalıkları, ÜSYE varlığı ve işitme azlığı şikayetinin başlaması ile tedavi başlangıcı arasında geçen süre açısından karşılaştırıldığında, gruplar arasında istatistiksel olarak anlamlı fark saptanmadı. Grupların tedavi etkinliği; işitme kazançları, işitme geri dönüş yüzdeleri ve Furuhashi kriterleri kullanılarak karşılaştırıldı ve gruplar arasında her üç parametrede de istatistiksel olarak anlamlı fark bulunmadı (sırasıyla p=0,815, p= 0,626, p= 0,853). AİK tedavisinde sistemik steroide çinko eklenmesi sonucunda iyileşme parametrelerinde istatistiksel olarak anlamlı bir değişim saptanmamıştır. Çinkonun AİK tedavisinde günümüz koşullarında kullanımının gerekli olmadığını düşünmekteyiz.

Anahtar Kelimeler

çinko, ani işitme kaybı, tedavi, antioksidan, antiinflamatuvar

Can Zinc Treatment Be Effective for Sudden Hearing Loss?

Öz

To investigate the efficacy of zinc, which is both an anti-inflammatory and an antioxidant, in the treatment of sudden sensorineural hearing loss (SSNHL). The present study was carried out retrospectively at a territory reference center upon the approval of the local ethics committee. Patients between the ages of 18-65 who used systemic steroid or zinc with systemic steroids for the treatment of SSNHL were included in the study. The patients were divided into two groups according to the type of treatment used. The patients who used systemic steroids were included in Group 1, and the patients who used zinc in addition to systemic steroids were included in Group 2. Recovery rate, hearing gain, and Furuhashi criteria were used to evaluate the treatment efficacy. Group 1 and Group 2 were compared in terms of treatment efficiency. A total of 76 patients, 40 in Group 1 and 36 in Group 2, who met the inclusion criteria, were included in the study. When the two groups were compared in terms of demographic data (age, gender), side of the ear with hearing loss, whether the disease was accompanied by vertigo and tinnitus, the patients' existing systemic diseases, the presence of upper respiratory tract infection, and the time elapsed between the onset of hearing loss and the beginning of treatment, there was no statistically significant difference between the groups.Treatment efficacies of groups were compared using the hearing gain, recovery rate, and Furuhashi criteria, and there was no statistically significant difference in all three parameters between the groups. (p = 0.815, p = 0.626, p = 0.853, respectively). As a result of the addition of zinc to systemic steroid in SSNHL treatment, no statistically significant change was found in healing parameters. We think that it is not necessary to use zinc in the treatment of SSNHL in today's conditions.

Anahtar Kelimeler

zinc, sudden sensorineural hearing loss, treatment, antioxidant, anti-inflammatory

Kaynakça

• 1. Hughes GB, Freedman MA, Haberkamp TJ et al. Sudden sensorineural hearing loss. Otolaryngol Clin North Am. 1996;29(3):393–405.
• 2. Eisenman D, Arts HA. Effectiveness of treatment for sudden sensorineural hearing loss. Arch Otolaryngol Head Neck Surg. 2000;126(9):1161-4.
• 3. Quaranta N, Ramunni A, De Luca C et al. Endothelial progenitor cells in sudden sensorineural hearing loss. Acta Otolaryngol. 2011;131(4):347-50.
• 4. Whitaker S. Idiopathic sudden hearing loss. Am J Otol.1980;1(3):180–3.
• 5. Robert JS, Sujana SC, Sanford MA et al. Clinical Practice Guideline:Sudden Hearing Loss. Otolaryngol Head Neck Surg. 2012;146(3):1–35.
• 6. Sujana SC, Betty ST, Seth RS et al. Clinical Practice Guideline: Sudden Hearing Loss (Update) Executive Summary. Otolaryngol Head Neck Surg. 2019;61(2):195–210.
• 7. Ibrahim I, Zeitouni A, Da Silva SD. Effect of Antioxidant Vitamins as Adjuvant Therapy for Sudden Sensorineural Hearing Loss: Systematic Review Study. Audiol Neurootol. 2018;23(1):1-7.
• 8. Yang CH, Tse Ko M, Peng JP et al. Zinc in the treatment of idiopathic sudden sensorineural hearing loss. Laryngoscope. 2011;121(3):617-21.
• 9. Shambaugh GE Jr. Zinc and presbycusis. Am J Otol. 1985;6(1):116–7.
• 10. Shambaugh GE Jr. Zinc for tinnitus, imbalance, and hearing loss in the elderly. Am J Otol. 1986;7(6):476–7.
• 11. Nakashima T, Sato H, Gyo K et al. Idiopathic sudden sensorineural hearing loss in Japan. Acta Otolaryngol. 2014;134(11):1158–63.
• 12. Joachims HZ, Segal J, Golz A et al. Antioxidants in treatment of idiopathic sudden hearing loss. Otol Neurotol. 2003;24(4):572–5.
• 13. Toroslu T, Erdoğan H, Çağlar Ö et al. Comparison of different treatment methods for idiopathic sudden sensorineural hearing loss. Turk Arch Otorhinolaryngol. 2018;56(4):226-32.
• 14. Körpinar S, Alkan Z, Yiğit O et al. Factors influencing the outcome of idiopathic sudden sensorineural hearing loss treated with hyperbaric oxygen therapy. Eur Arch Otorhinolaryngol. 2011;268(1):41-7.
• 15. Clerici WJ, DiMartino DL, Prasad MR. Direct effects of reactive oxygen species on cochlear outer hair cell shape in vitro. Hear Res. 1995;84(1-2):30-40.
• 16. Nordang L, Anniko M. Nitro-L-arginine methyl ester: a potential protector against gentamicin ototoxicity. Acta Otolaryngol. 2005;125(10):1033-8.
• 17. Kaya H, Karaman Koç A, Sayın I et al. Vitamins A, C, and E and selenium in the treatment of idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol. 2015;272(5):1119-25.
• 18. Rybak LP, Whitworth C, Somani S. Application of antioxidants and other agents to prevent cisplatin ototoxicity. Laryngoscope. 1999;109(11):1740–4.
• 19. Takumida M, Anniko M. Functional significance of nitric oxide in the inner ear. In Vivo. 2004;18(3):345–50. 20. Darrat I, Ahmad N, Seidman K et al. Auditory research involving antioxidants. Curr Opin Otolaryngol Head Neck Surg. 2007;15(5):358–63.
• 21. Young IS, Woodside JV. Antioxidants in health and disease. J Clin Pathol. 2001;54(3):176–86.
• 22. Sensi SL, Paoletti P, Bush AI et al. Zinc in the physiology and pathology of the CNS. Nat Rev Neurosci. 2009;10(11):780–91.
• 23. Zirpel L, Parks TN. Zinc inhibition of group I mGluR-mediated calcium homeostasis in auditory neurons. J Assoc Res Otolaryngol. 2001;2(2):180-7.
• 24. Rarey KE, Yao X. Localization of Cu/Zn-SOD and Mn-SOD in the rat cochlea. Acta Otolaryngol. 1996;116(6):833–5.
• 25. Karabulut H,Gülay MS. Antioksidanlar. MAE Vet Fak Derg. 2016;1(1):65-76.
• 26.Sen S, Chakraborty R, Sridhar C et al. Free radicals, antioxidants, diseases and phytomedicines: Current status and future prospect. Int J Pharm Sci Res. 2010;3(1):91-100.
• 27. Gunther T, Rebentisch E, Vormann J et al. Enhanced ototoxicity of gentamicin and salicylate caused by Mg deficiency and Zn deficiency. Biol Trace Elem Res. 1988;16(1):43-50.
• 28. Franco-Vidal V, Beurg M, Darrouzet V et al. Zinc protection against pneumolysin toxicity on rat cochlear hair cells. Audiol Neurootol. 2008;13(1):65-70.
• 29. Agirdir BV, Bilgen I, Dinc O et al. Effect of zinc ion on cadmium induced auditory changes. Biol Trace Elem Res. 2002;88(2):153-63.
• 30.Hunchaisri N, Chantapant S, Sirirattanapan J. Effectiveness of oral zinc supplementation in the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL). J Med Assoc Thai. 2015;98(4):400-7.