고도 및 심도 돌발성 난청에 대한 고실내 스테로이드 주입술과 경구 스테로이드 병합치료의 효과
The Effects of Combined Intratympanic and Oral Steroid Treatment for Severe to Profound Sudden Sensorineural Hearing Loss
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
most commonly accepted treatment. Recently, intratympanic steroid injection has been proposed as a safe and an effective in the salvage therapy. However, treatment protocol for severe to profound SSNHL has not been established. As there has been little discussion about the efficacy of combined method, this study aims to evaluate the effects of combined intratympanic and oral steroid treatment compared with oral steroid therapy alone for severe to profound SSNHL. Methods：We reviewed the medical records of patients with severe to profound SSNHL between January 2009 and February 2012, and 34 patients were categorized into the oral steroid treatment alone group (PO group). And 33 patients of combined intratympanic and oral steroid treatment group (CT group) were evaluated from March 2012 to June 2015. We compared demographics, clinical findings, audiological results, and treatment outcomes between two groups. Results：Significant difference of hearing recovery was identified between PO group and CT group. The mean PTA gain was 23.5±18.3 dB in PO group and 31.6±13.2 dB in CT group (p=0.048). When Siegel’s criteria was used, more patients showed significant hearing improvement in CT group than in PO group (p=0.0204). Conclusions：This study concluded that the combined intratympanic and oral steroid treatment might lead to favorable hearing outcomes when compared with the oral steroid treatment alone. We recommend that the combined treatment could be considered as primary management for patients with severe to profound SSNHL.
Abstract
most commonly accepted treatment. Recently, intratympanic steroid injection has been proposed as a safe and an effective in the salvage therapy. However, treatment protocol for severe to profound SSNHL has not been established. As there has been little discussion about the efficacy of combined method, this study aims to evaluate the effects of combined intratympanic and oral steroid treatment compared with oral steroid therapy alone for severe to profound SSNHL. Methods：We reviewed the medical records of patients with severe to profound SSNHL between January 2009 and February 2012, and 34 patients were categorized into the oral steroid treatment alone group (PO group). And 33 patients of combined intratympanic and oral steroid treatment group (CT group) were evaluated from March 2012 to June 2015. We compared demographics, clinical findings, audiological results, and treatment outcomes between two groups. Results：Significant difference of hearing recovery was identified between PO group and CT group. The mean PTA gain was 23.5±18.3 dB in PO group and 31.6±13.2 dB in CT group (p=0.048). When Siegel’s criteria was used, more patients showed significant hearing improvement in CT group than in PO group (p=0.0204). Conclusions：This study concluded that the combined intratympanic and oral steroid treatment might lead to favorable hearing outcomes when compared with the oral steroid treatment alone. We recommend that the combined treatment could be considered as primary management for patients with severe to profound SSNHL.
참고문헌 (25)
- Stew BT, "Sudden sensorineural hearing loss", Br J Hosp Med (Lond), 73(2), pp.86~89 (2012)
- Wilson WR, "The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study", Arch Otolaryngol, 106(12), pp.772~776 (1980)
- Stachler RJ, "Clinical practice guideline: sudden hearing loss", Otolaryngol Head Neck Surg, 146(3 Suppl), pp.S1~S35 (2012)
- Rauch SD, "Oral vs. intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: a randomized trial", JAMA, 305(20), pp.2071~2079 (2011)
- 강우석, "돌발성 난청의 치료 원칙", 대한이비인후과학회지 두경부외과학, 54(10), pp.675~682 (2011), 대한이비인후과학회
- Bordley JE, "Viral infections and hearing: a critical review of the literature, 1969-1970", Laryngoscope, 82(4), pp.557~577 (1972)
- Kimura R, "Extensive venous obstruction of the labyrinth. A Cochlear changes", Ann Otol Rhinol Laryngol, 65(2), pp.332~350 (1956)
- Gussen R, "Sudden hearing loss associated with cochlear membrane rupture. Two human temporal bone reports", Arch Otolaryngol, 107(10), pp.598~600 (1981)
- 최영호, "돌발성 난청 환자군에서 청성안정유발반응검사의 진단적 가치 분석", 대한이비인후과학회지 두경부외과학, 58(4), pp.243~248 (2015), 대한이비인후과학회[DOI]
- 박창호, "노인 돌발성 난청 환자의 임상적 특징 및 예후인자에 대한 분석", 대한이비인후과학회지 두경부외과학, 57(8), pp.511~517 (2014), 대한이비인후과학회[DOI]
- Fetterman BL, "Prognosis and treatment of sudden sensorineural hearing loss", Am J Otol, 17(4), pp.529~536 (1996)
- Lin CF, "Effect of comorbid diabetes and hypercholesterolemia on the prognosis of idiopathic sudden sensorineural hearing loss", Laryngoscope (2015)
- Quaranta N, "High total cholesterol in peripheral blood correlates with poorer hearing recovery in idiopathic sudden sensorineural hearing loss", PLoS One, 10(7), pp.e0133300~ (2015)
- Fattori B, "Sudden hypoacusis treated with hyperbaric oxygen therapy: a controlled study", Ear Nose Throat J, 80(9), pp.655~660 (2001)
- Silverstein H, "Intratympanic steroid treatment of inner ear disease and tinnitus (preliminary report)", Ear Nose Throat J, 75(8), pp.468~471 (1996)
- Spear SA, "Intratympanic steroids for sudden sensorineural hearing loss: a systematic review", Otolaryngol Head Neck Surg, 145(4), pp.534~543 (2011)
- 한치성, "당뇨환자에서 발생한 돌발성 난청에 대한 스테로이드 전신 투여와 고실내 주입의 치료효과 비교", 대한이비인후과학회지 두경부외과학, 51(3), pp.227~233 (2008), 대한이비인후과학회
- Hong SM, "Hearing outcomes of daily intratympanic dexamethasone alone as a primary treatment modality for ISSHL", Otolaryngol Head Neck Surg, 141(5), pp.579~583 (2009)
- Battaglia A, "Combination therapy (intratympanic dexamethasone+high-dose prednisone taper) for the treatment of idiopathic sudden sensorineural hearing loss", Otol Neurotol, 29(4), pp.453~460 (2008)
- Ahn JH, "Can intratympanic dexamethasone added to systemic steroids improve hearing outcome in patients with sudden deafness?", Laryngoscope, 118(2), pp.279~282 (2008)
- 이종대, "Intratympanic Steroids in Severe to Profound Sudden Sensorineural Hearing Loss as Salvage Treatment", Clinical and Experimental Otorhinolaryngology, 3(3), pp.122~125 (2010), 대한이비인후과학회
- 박상철, "돌발성 난청 환자에서 고실내 스테로이드 주입술 시기에 따른 청력 개선 효과", 대한이비인후과학회지 두경부외과학, 56(1), pp.19~22 (2013), 대한이비인후과학회[DOI]
- Hirano K, "Prognosis of sudden deafness with special reference to risk factors of microvascular pathology", Auris Nasus Larynx, 26(2), pp.111~115 (1999)
- Siegel LG, "The treatment of idiopathic sudden sensorineural hearing loss", Otolaryngol Clin North Am, 8(2), pp.467~473 (1975)
- Cho CH, "Analysis of prognostic factors in patients with sudden sensorineural hearing loss", J Clinical Otolaryngol, 16(1), pp.89~95 (2005)