Hyperbaric oxygen treatment in sudden hearing loss after unsuccessful medical treatment

Yıl 2002, Cilt: 9 Sayı: 5, 337 - 341, 10.10.2002

Ender İnci Ferhat Erişir Mehmet Ada Özcan Öztürk Ender Güçlü Fatih Öktem Murat Toprak

Öz

Objectives: We evaluated the efficacy of hyperbar­ ic oxygen HBO treatment in patients with sudden hearing loss unresponsive to medical treatment.Patients and Methods: Fifty-one patients 37 males, 14 females; mean age 37 years; range 9 to 63 years with sudden hearing loss were treated with HBO follovv- ing unsuccessful medical treatment. Time elapsed from the occurrence of sudden hearing loss ranged betvveen 15 to 45 days. Treatment included two sessions daily for the first three days, followed by a single daily session, to make 20 sessions of 90 minutes. Treatment was dis- continued because of early recovery in two patients.Audiometric examinations were made at the end of every five sessions. The patients were classified according to age, gender, and audiogram curves.Results: The mean hearing thresholds were 75.3 dB and 65.6 dB before and after treatment, respectively. Recovery was rated as complete in two patients 3.9% , moderate in two patients 3.9% , mild in 19 patients 37.25% , and as no recovery in 28 patients 54.9% . No significant differ- ences were found betvveen the patient groups in terms of improvement and hearing gain p>0.05 .Conclusion: We propose that HBO be resorted to when other means of medical treatment proves unsuccessful in patients with sudden hearing loss.

Anahtar Kelimeler

Deafness, sudden/therapy, hearing loss/therapy, hyperbaric oxygenation

Medikal tedavinin başarısız olduğu ani işitme kayıplı olgularda hiperbarik oksijen tedavisi

Öz

Amaç: Medikal tedaviyle düzelme sağlanamadığıiçin geç baflvuran ani iflitme kayıplı olgularda hiperbarik oksijen tedavisinin HBO etkinliği arafltırıldı. Hastalar ve Yöntemler: En az 15 gündür ani iflitmekaybı flikayeti olan ve uygulanan medikal tedaviyledüzelme sağlanamayan 51 hastaya ilk üç gün, günde ikiseans 1 seans=90 dak , sonraki günlerde günde birseans olmak üzere toplam 20 seans HBO tedavisiuygulandı. Tam düzelme sağlanan iki hastada tedavi erken sonlandırıldı. Kontrol odyogramları befl seanslık aralıklarla yapıldı. Hastalar yafl 45 yafl ve altı- 46 yafl üzeri , cinsiyet ve odyogram eğrisinin flekline çıkan, düz ve inen göre gruplandırıldı. Tedavisonrası iflitme kazancı ve iyileflme değerlendirildi.Bulg u l a r : Saf-ses iflitme eflikleri ortalamaları HBO tedavisi öncesi ve sonrasında sırasıyla 75.3 dB ve 65.6dB bulundu. İki hastada %3.9 tam, iki hastada %3.9 belirgin, 19 hastada %37.25 hafif iyileflme gözlenirken, 28 hastada %54.9 düzelme olmadı. Hasta grupları arasında tedavi sonrası iyileflme ve kazanç açısından anlamlı farklılık saptanmadı p>0.05 .Sonuç: Medikal tedaviye rağmen iflitmede düzelmesağlanamamıfl ani iflitme kayıplı olgularda HBO tedavisinin yararlı olma olasılığı dikkate alınmalıdır

Anahtar Kelimeler

Sağırlık, ani/tedavi, iflitme kaybı/tedavi, hiperbarik oksijenasyon

Kaynakça

• Trump BF, Berezesky JK, Cowley RA. The cellular and subcellular characteristics of acute and chronic injury with emphasis on the role of calcium. In: Cowley RA, Trump BF, editors. Pathophysiology of shock, anoxia and ischemia. 1st ed. Baltimore: Williams & Wilkins; 1982. p. 6.
• Lamm K, Lamm C, Lamm H, Schumann K. Simultane S a u e r s t o ff p a r t i a l d ruck-Bestimmungen in der Scala tympani, Elektrokochleographie und Blutdru c k - Messungen unter Larmbelastungen bei Meerschweinchen. HNO 1988;36:367-72.
• Byl FM Jr. Sudden hearing loss: eight years' experience and suggested prognostic table. Laryngoscope 1984;94: 647-61.
• Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86:463-80.
• Shikowitz MJ. Sudden sensorineural hearing loss. Med Clin North Am 1991;75:1239-50.
• Wilson WR, Gulya AJ. Sudden sensorineural hearing loss. In: Cummings CW, editor. Otolaryngology- head and neck surgery. 2nd ed. St. Louis: Mosby Year Book; 1993. p. 3103-11.
• Matsuoka A, Shitara T, Okamoto M, Sano H. Transient deafness with iopamidol following angiography. Acta Otolaryngol Suppl 1994;514:78-80.
• Cavallazzi GM, Oriani G, Zurlo T, Montino O, Michael M, Prendini P, et al. HBO and the physiopathology of the auditory function. In: Reinertsen RE, Brubakk AO, Bolstad G, editors. Proceedings of the 19th Annual Meeting of EUBS. August 17-20, 1993; Tro n d h e i m , N o r w a y. Trondheim: Sintef Unimed; 1993. p. 131-6.
• Hoffmann G, Bohmer D, Desloovere C. Hyperbaric oxygenation as a treatmant for sudden deafness and acute tinnitus. In: Proceedings of 11th International Congress on Hyperbaric Medicine. Fuzhou, China. Flagstaff, Arizona: Best Publishing; 1993. p. 146-52.
• Miyake H, Yanagita N. Therapy of sudden deafness. Acta Otolaryngol Suppl 1988;456:27-30.
• Takahashi H, Sakakibara K, Murahashi K, Yanagita N. HBO for sudden deafness-a statistical survey over 907 ears. In: Bakker DJ, Schmutz J, editors. 2nd Swiss Symposium on HBO. September, 1988; Basel: Switzerland. Basel: Foundation for Hyperbaric Medicine; 1990. p. 249-58.
• Basset BE, Bennett PB. Introduction to the physical and physiological bases of hyperbaric therapy. In: Hunt TK, Davis JC, editors. Hyperbaric oxygen therapy. Maryland: Undersea Medical Society Inc; 1977. p. 11 - 2 4 .
• Cimflit M. Hiperbarik oksijen tedavisi. Sendrom 1990; 6:67-9.
• Davis JC, Hunt TK (editors). Hyperbaric oxygen ther- a p y, preface and background undersea. Bethesda: Medical Society Inc; 1977.
• Myers RA. Hyperbaric oxygen therapy: a committee report. In: Radomski MW, editor. Bethesda: Undersea and Hyperbaric Medical Society Inc; 1986. p. 111-28.
• Skyhar MJ, Hargens AR, Strauss MB, Gershuni DH, Hart GB, Akeson WH. Hyperbaric oxygen reduces edema and necrosis of skeletal muscle in compartment syndromes associated with hemorrhagic hypotension. J Bone Joint Surg [Am] 1986;68:1218-24.
• Schumann K, Lamm K, Hettich M. Zur Wirkung und Wirksamkeit der hyperbaren Sauerstofftherapie bei alten Horstorungen. Bericht uber 557 Falle aus dem Jahre 1989. HNO 1990;38:408-11.
• Lamm K, Lamm H, Arnold W. Effect of hyperbaric oxy- gen therapy in comparison to conventional or placebo therapy or no treatment in idiopathic sudden hearing loss, acoustic trauma, noise-induced hearing loss and tin- nitus. A literature survey. Adv Otorhinolaryngol 1 9 9 8 ; 5 4 : 8 6 - 9 9 .
• Akkafl B. Ani iflitme kaybı olgularında hiperbarik oksi- jen tedavisinin etkinliği [Uzmanlık Tezi]. İstanbul Üniversitesi İstanbul Tıp Fakültesi Deniz ve Sualtı Hekimliği Anabilim Dalı. İstanbul: 1996.
• Aslan I, Oysu C, Veyseller B, Baserer N. Does the addition of hyperbaric oxygen therapy to the conven- tional treatment modalities influence the outcome of sudden deafness? Otolaryngol Head Neck Surg. 2002; 1 2 6 : 1 2 1 - 6 .