Çocuklarda Ani İşitme Kaybında Hiperbarik Oksijen Tedavisinin Yeri

Öz

Amaç: Ani Sensörinöral İşitme Kaybı (ASNIK) otolojik bir acil durumdur. Kalıcı ASNIK, çocuk hastaların sosyal yaşamını, psikolojisini ve dil gelişimini ciddi şekilde etkileyebilir. ASNIK tedavisi konusunda fikir birliği yoktur. ASNIK tanısı ile sistemik steroid tedavisine ek olarak hiperbarik oksijen tedavisi (HBOT) alan çocuk hastalarda etiyoloji, prognostik faktörler ve tedavi sonuçları karşılaştırıldı.

Gereç ve Yöntemler: ASNIK tanısı ile HBOT uygulanan 8-18 yaşları arasında en az üç ay takip edilen 15 çocuğun dosyaları geriye dönük olarak incelendi.

Bulgular: ASNIK’li hastaların yaşları 8 ile 18 yaş arasındaydı (ortalama 14.47±3.31 yıl). Yedi (% 46.7) hastada tam iyileşme, iki (%13.3) hastada kısmi iyileşme, iki (% 13.3) hastada hafif iyileşme, dört (% 26.7) hastada düzelme olmadı. Hastaların tedavi öncesi Saf Ses Ortalamaları (SSO) 28 ile 109 dB HL (ortalama±ss; 57.3±26.2 dB HL) arasında değişirken, tedavi sonrası PTA’ları 6 ile 88 dB HL (38±27.3 dB HL), (p=0.002 ). Yaş, cinsiyet, HBOT seans sayısı ve tedaviye yanıt arasında anlamlı bir fark bulunmadı (sırasıyla p = 0.581, p = 0.904, p = 0.357, p = 0.184).

Sonuç: Hiperbarik oksijen tedavisi, pediatrik SSNHL hastaları için güvenli ve iyi tolere edilen bir tedavi yöntemidir. Etik ve yasal sorunlara yol açmamak için ASNIK tanısı alan çocuk hastaların ailelerinin onayı ile tedaviye başlanması gerektiğini düşünüyoruz.

Anahtar Kelimeler

• Ani İşitme Kaybı
• prognoz
• çocuk
• ergen
• hiperbarik oksijen tedavisi

The Role of Hyperbaric Oxygen Therapy in Sudden Sensorineural Hearing Loss in Children

Öz

Objective: Sudden Sensorineural Hearing Loss (SSNHL) is an otological emergency. Permanent SSNHL can seriously affect the social life, psychology, and language development of pediatric patients. There is no consensus the treatment of SSNHL. We compared the etiology, prognostic factors, and treatment results in pediatric patients who received hyperbaric oxygen therapy (HBOT) in addition to systemic steroid therapy with a diagnosis of SSNHL.

Material and Methods: The files of 15 children were received HBOT with the diagnosis of SSNHL, between the ages of 8-18 years, and followed-up at least three months were retrospectively analyzed.

Results: The ages of patients with SSNHL ranged from 8 to 18 years of age (mean 14.47±3.31 years). Seven (46.7%) patients had complete recovery, and two (13.3%) patients had partial recovery, two (13.3%) patients had slight recovery, four (26.7%) patients had no improvement. While pre-treatment PTAs of the patients were ranged between 28 to 109 dB HL (mean±sd; 57.3±26.2 dB HL), post-treatment PTAs were 6 to 88 dB HL (38±27.3 dB HL), (p=0.002). No significant difference was found between age, gender, number of HBOT sessions and response to treatment (p = 0.581, p = 0.904, p = 0.357, p = 0.184, respectively).

Conclusion: Hyperbaric oxygen therapy is a safe and well-tolerated treatment modality for pediatric SSNHL patients. To avoid ethical and legal problems, we think that pediatric patients with a diagnosis of SSNHL should be initiated with the consent of the patient’s parents.

Anahtar Kelimeler

• Sudden Hearing Loss
• prognosis
• child
• adolescent
• hyperbaric oxygen therapy

Kaynakça

1. Kenna MA. Acquired hearing loss in children. Otolaryngol Clin North Am 2015;48:933–53.
2. Kizilay A, Koca ÇF. Pediatric sudden sensorineural hearing loss. J Craniofac Surg 2016;27: 364–6.
3. Alexander TH, Harris JP. Incidence of sudden sensorineural hearing loss. Otol Neurotol 2013;34:1586–9.
4. Lu Y, Zhou L, Amrit TS, Liu A. Sudden Sensorineural Hearing Loss in Children: Clinical Characteristics, Etiology, Treatment Outcomes, and Prognostic Factors. Otol Neurotol 2019;40:446-53.
5. Dedhia K, Chi DH. Pediatric sudden sensorineural hearing loss: Etiology, diagnosis, and treatment in 20 children. Int J Pediatr Otorhinolaryngol 2016;88:208–12.
6. Kuchar E, Carowicz G. Hyperbarıc Oxygen Therapy in Pediatrics. Polish Hyperbaric Research 2018;62;55-60.
7. Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med 2017;47:24-32.
8. Horn CE, Himel HN, Selesnick SH Hyperbaric oxygen therapy for sudden sensorineural hearing loss: a prospective trial of patients failing steroid and antiviral treatment. Otol Neurotol 2005;26:882–9.

9. Eryigit B, Ziylan F, Yaz F, Thomeer H. The effectiveness of hyperbaric oxygen in patients with idiopathic sudden sensorineural hearing loss: a systematic review. Eur Arch Otorhinolaryngol 2018;275:2893-904.
10. Keseroğlu K, Toptaş G, Uluat A, Bayir Ö, Çadalli Tatar E, Saylam G, et al. Addition of intratympanic steroid or hyperbaric oxygen treatment to systemic steroid treatment in sudden idiopathic sensorineural hearing loss treatment, and long-term results of salvage treatment. Turk J Med Sci 2020;50:177-83.
11. Bennett M, Kertesz T,Yeung P Hyperbaric oxygen for idiopathic sudden sensorineurol hearing loss and tinnitus. Cochrane Database Syst Rev 2007;1:CD004739
12. Bayoumy AB, de Ru JA. The use of hyperbaric oxygen therapy in acute hearing loss: a narrative review. Eur Arch Otorhinolaryngol 2019;276:1859-80.
13. Siegel L. The treatment of idiopathic sudden sensorineural hearing loss. Otolaryngol Clin North Am 1975;8:467.
14. Kasapoglu F, Tuzemen G, Hızalan I, Erisen L, Basut O, Onart S, et al. Prognosis in sudden hearing loss: is it the disease or the treatment that determines the prognosis?. Int Adv Otol 2009;5:187-94.
15. Lim HJ, Kim YT, Choi SJ, Lee BJ, Park HY, Park K, et al. Efficacy of 3 different steroid treatments for sudden sensorineural hearing loss: a prospective, randomized trial. Otolaryngol Head Neck Surg 2013;148:121–7.
16. Goto F, Fujita T, Kitani Y, Kanno M, Kamei T, Ishii H. Hyperbaric oxygen and stellate ganglion blocks for idiopathic sudden hearing loss. Acta Otolaryngol 1979;88:335-42.
17. Rhee TM, Hwang D, Lee JS, Park J, Lee JM. Addition of hyperbaric oxygen therapy vs medical therapy alone for idiopathic sudden sensorineural hearing loss: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 2018;144:1153-61.
18. Hosokawa S, Sugiyama K, Takahashi G, Takebayashi S, Mineta H. Prognostic factors for idiopathic sudden sensorineural hearing loss treated with hyperbaric oxygen therapy and intravenous steroids. J Laryngol Otol 2017;131:77-82.
19. Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA. Clinical Practice Guideline: Sudden Hearing Loss. Otolaryngol Head Neck Surg 2019;161:1-45.
20. Choi Y, Choi HL, Jeong AY, Kang WS, Park HJ, Chung JW, et al. Hyperbaric oxygen (HBO) therapy as an effective approach to the treatment of patients with severe idiopathic sudden sensorineural hearing loss. Acta Otolaryngol 2020;140:383-6.
21. Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM,et al. Clinical practice guideline: Sudden hearing loss. Otolaryngol Head Neck Surg 2012;146:35.
22. Skarzynski PH, Rajchel J, Skarzynski H. Sudden Sensorineural Hearing Loss in Children: A Literature Review. Journal of Hearing Science 2016;6:9-18.
23. Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463-80.
24. Gomez-Castillo JD, Bennett MH. The cost of hyperbaric therapy at the Prince of Wales Hospital, Sydney. S Pac Underw Med Soc J 2005;35:194–8.