The importance of the first three days and other diagnostic indicators in sudden hearing loss

Abstract

Objectives: This study aims to compare different therapy methods used for sudden sensorineural hearing losses, to determine the prognostic factors and particularly to investigate the importance of starting the therapy within the first three days of the prognosis. Patients and Methods: Between January 1995 and December 2008, the files of 213 patients who were treated in our clinic were reviewed. A total of 155 patients who met the inclusion criteria were included in the study. The study groups were classified according to the prognostic and audiometric factors. Results: With regard to the effectiveness of treatment options, post-treatment audiometric improvement was significantly better in the patients treated with carbogen in addition to the medical therapy compared to the other groups p=0.018 . In terms of the patient characteristics at the time of admission, having vertigo, presence of a descending type audiogram curve and severe hearing loss affected the success of treatment negatively, while mild hearing loss and presence of an ascending type audiogram curve had a positive effect. The recovery rate was higher in patients who were admitted within the first three days p=0.005 . Conclusion: It was found that starting the therapy within the first three days and adding the carbogen to the conventional medical treatment may improve the outcome of the treatment.

Keywords

• Carbogen, first three days, prognosis, sudden hearing loss

Ani işitme kaybında ilk üç günün ve diğer tanı göstergelerinin önemi

Abstract

Amaç: Bu çalışmada ani sensörinöral işitme kayıpları için kullanılan farklı tedavi yöntemleri karşılaştırıldı, prognostik faktörler belirlendi ve özellikle prognozun ilk üç gününde tedaviye başlamanın önemi araştırıldı.Hastalar ve Yöntemler: Bu çalışmada Ocak 1995 - Aralık 2008 tarihleri arasında kliniğimizde tedavi edilen 213 hastanın dosyaları incelendi. Çalışma kriterlerini karşılayan toplam 155 hasta çalışmaya dahil edildi. Çalışma grupları prognostik ve odyometrik faktörlere göre sınıflandı.Bulgular: Tedavi seçeneklerinin etkililiği ile ilgili olarak, tıbbi terapiye ek olarak karbojen ile tedavi edilen hastalarda tedavi sonrası odyometrik iyileşme diğer gruplarla karşılaştırıldığında anlamlı olarak daha iyiydi p=0.018 . Başvuru sırasında hasta özellikleri açısından baş dönmesi, odyogramda alçalan eğri ve ciddi işitme kaybı tedavinin başarısını olumsuz etkilerken, hafif işitme kaybı ve odyogramda yükselen eğrinin varlığı tedavi için olumlu bir etkiye sahiptir. İlk üç gün içinde başvuran hastalarda iyileşme oranı daha yüksekti p=0.005 .Sonuç: Tedaviye ilk üç gün içinde başlamanın ve konvansiyonel tıbbi tedaviye karbojenin eklenmesinin tedavinin sonucunu iyileştirebileceği gözlendi

Keywords

• Karbojen, ilk üç gün, prognoz, ani işitme kaybı

References

1. Lamm K, Lamm C, Arnold W. Effect of isobaric oxygen versus hyperbaric oxygen on the normal and noise-damaged hypoxic and ischemic guinea pig inner ear. Adv Otorhinolaryngol 1998;54:59-85.
2. Shikowitz MJ. Sudden sensorineural hearing loss. Med Clin North Am 1991;75:1239-50.
3. Herr BD, Marzo SJ. Intratympanic steroid perfusion for refractory sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2005;132:527-31.
4. Byl FM Jr. Sudden hearing loss: eight years' experience and suggested prognostic table. Laryngoscope 1984;94:647-61.
5. Psifidis AD, Psillas GK, Daniilidis JCh. Sudden sensorineural hearing loss: long-term follow-up results. Otolaryngol Head Neck Surg 2006;134:809-15.
6. Eisenman D, Arts HA. Effectiveness of treatment for sudden sensorineural hearing loss. Arch Otolaryngol Head Neck Surg 2000;126:1161-4.
7. Han DH, Kim HJ. Effect of etiologic factors on prognosis of hearing recovery in sudden deafness. Korean J Otolaryngol 2002;45:936-41.
8. Lee JK, Seo DJ, Cho HH, Cho Y, Kim HJ, Cho YB. A study on the hearing recovery patterns in sudden sensorineural hearing loss patients. Korean J Otolaryngol 2002;45:656–61.

9. Takeshi Kubo, Tohru Matsunaga, Hideyo Asai, Kazutomo Kawamoto, Jun Kusakari, Yasuya Nomura, et al. Efficacy of defibrinogenation and steroid therapies on sudden deafness. Arch Otolaryngol Head Neck Surg 1988;114:649-52.
10. Wilson WR, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol 1980;106:772-6.
11. Ho HG, Lin HC, Shu MT, Yang CC, Tsai HT. Effectiveness of intratympanic dexamethasone injection in sudden- deafness patients as salvage treatment. Laryngoscope 2004;114:1184-9.
12. Mattox DE, Lyles CA. Idiopathic sudden sensorineural hearing loss. Am J Otol 1989;10:242-7.
13. Mamak A, Yilmaz S, Cansiz H, Inci E, Güçlü E, Dereköylü L. A study of prognostic factors in sudden hearing loss. Ear Nose Throat J 2005;84:641-4.
14. Hughes GB, Freedman MA, Haberkamp TJ, Guay ME. Sudden sensorineural hearing loss. Otolaryngol Clin North Am 1996;29:393-405.
15. Nosrati-Zarenoe R, Hansson M, Hultcrantz E. Assessment of diagnostic approaches to idiopathic sudden sensorineural hearing loss and their influence on treatment and outcome. Acta Otolaryngol 2010;130:384-91.
16. Huy PT, Sauvaget E. Idiopathic sudden sensorineural hearing loss is not an otologic emergency. Otol Neurotol 2005;26:896-902.
17. Anderson RG, Meyerhoff WL. Sudden sensorineural hearing loss. Otolaryngol Clin North Am 1983;16:189-95.
18. Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463-80.
19. İnanlı S, Polat Ş, Tutkun A, Batman Ç, Üneri C, Şehitoğlu MA. Ani işitme kayıplı hastalarımızın tedavi ve prognozun retrospektif analizi. Türk Otolaringoloji Arşivi 2002;40:196-200.
20. Cinamon U, Bendet E, Kronenberg J. Steroids, carbogen or placebo for sudden hearing loss: a prospective double-blind study. Eur Arch Otorhinolaryngol 2001;258:477-80.
21. Fisch U. Management of sudden deafness. Otolaryngol Head Neck Surg 1983;91:3-8.
22. Chen CY, Halpin C, Rauch SD. Oral steroid treatment of sudden sensorineural hearing loss: a ten year retrospective analysis. Otol Neurotol 2003;24:728-33.
23. Kasapoglu F, Tuzemen G, Hizalan I, Erişen 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.
24. Lee HJ, Park CY, Lee JH, Yang HS, Kim JH, Ban MJ, et al. Therapeutic effects of carbogen inhalation and lipo- prostaglandin E1 in sudden hearing loss. Yonsei Med J 2012;53:999-1004.
25. Park SN, Yeo SW, Park KH. Serum heat shock protein 70 and its correlation with clinical characteristics in patients with sudden sensorineural hearing loss. Laryngoscope 2006;116:121-5.
26. Nakashima T, Yanagita N. Outcome of sudden deafness with and without vertigo. Laryngoscope 1993;103:1145-9.
27. Lee HS, Lee YJ, Kang BS, Lee BD, Lee JS. A clinical analysis of sudden sensorineural hearing loss cases. Korean J Audiol 2014;18:69-75.
28. Atay G, Kayahan B, Çınar BÇ, Saraç S, Sennaroğlu L. Prognostic Factors in Sudden Sensorineural Hearing Loss. Balkan Med J 2016;33:87-93.
29. Anadolu Y, Demireller A, Esmer N. Ani işitme kayıplarında ürografin tedavisi. KBB ve baş boyun cerrahisi dergisi 1993;1:1-4.
30. Danino J, Joachims HZ, Eliachar I, Podoshin L, Ben- David Y, Fradis M. Tinnitus as a prognostic factor in sudden deafness. Am J Otolaryngol 1984;5:394-6.
31. Wilkins SA Jr, Mattox DE, Lyles A. Evaluation of a “shotgun” regimen for sudden hearing loss. Otolaryngol Head Neck Surg 1987;97:474-80.
32. Simmons FB. Sudden idiopathic sensori-neural hearing loss: some observations. Laryngoscope 1973;83:1221-7.
33. Fetterman BL, Saunders JE, Luxford WM. Prognosis and treatment of sudden sensorineural hearing loss. Am J Otol 1996;17:529-36.
34. Şanlı A. Ani işitme kayıplarında uyguladığımız tedavi protokolleri ve sonuçları. Türk Otolaryngoloji Arşivi 1992;30:141-3.
35. Celik O, Gök Ü, Yalçın Ş, Yanık H, Hançer A, Kaygusuz İ, Susaman N. Ani işitme kayıplı hastalarımızın retrospektif analizi. Kulak Burun Bogaz Ihtis Derg 1997:4:39-42.