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돌발성 난청에서 스테로이드 투여 방법에 따른 치료 결과의 차이

The Comparison of Treatment Outcomes between IV and Oral Steroid in Sudden Sensorineural Hearing Loss ; Propensity Score Matching Analysis

이승환|김동환|윤형준|김인식|정재호|박철원
대한이비인후과학회 부산,울산,경남 지부회 (The Busan, Ulsan, Gyeoungnam Branch of The Korean Society of Otolaryngology)|2017.06|임상이비인후과 (Journal of Clinical Otolaryngology)|제28권 제1호|pp. 42-48|DOI 10.35420/jcohns.2017.28.1.42

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키워드

돌발성난청·스테로이드.Sudden sensorineural hearing lossㆍSteroid.
주제분류이비인후과학

초록

The aims of the study was to compare the treatment outcomes associated with the steroid administration routes in unilateral sudden sensorineural hearing loss. Methods：From January 1998 to December 2014, three hundred and eighteen patients with unilateral sudden sensorineural hearing loss were assessed. Among them, 34 patients received the intravenous dexamethasone (16 mg/day)while the others 284 patients received 1mg/kg prednisolone daily with a subsequently tapered dose. We performed a propensity score matching analysis using previously known prognostic factors including initial hearing level, presence of vertigo and duration of onset of treatment to compare treatment outcome of IV and oral steroid. The hearing recovery between the IV steroid group and propensity score matched oral steroid group was assessed according to the AAO-HNS guideline and Siegel’s criteria. Results：In the comparison between oral and IV steroid group, mean age, the initial hearing level was significantly higher in the oral steroid group than in IV steroid group (p=0.002, p=0.003) After propensity score matching, initial hearing level, age, sex and other clinical parameters were not significantly different between IV steroid and matched oral steroid group. In the treatment outcome, the complete recovery rate in IV steroid and the oral steroid group were 64.7% and 47.1% respectively. Although the recovery rate of the IV steroid group was higher than that of the oral steroid group, statistical significance was not identified. Conclusions：The administration route of systemic steroid did not affect the clinical outcomes of idiopathic sudden sensorineural hearing loss.

Abstract

The aims of the study was to compare the treatment outcomes associated with the steroid administration routes in unilateral sudden sensorineural hearing loss. Methods：From January 1998 to December 2014, three hundred and eighteen patients with unilateral sudden sensorineural hearing loss were assessed. Among them, 34 patients received the intravenous dexamethasone (16 mg/day)while the others 284 patients received 1mg/kg prednisolone daily with a subsequently tapered dose. We performed a propensity score matching analysis using previously known prognostic factors including initial hearing level, presence of vertigo and duration of onset of treatment to compare treatment outcome of IV and oral steroid. The hearing recovery between the IV steroid group and propensity score matched oral steroid group was assessed according to the AAO-HNS guideline and Siegel’s criteria. Results：In the comparison between oral and IV steroid group, mean age, the initial hearing level was significantly higher in the oral steroid group than in IV steroid group (p=0.002, p=0.003) After propensity score matching, initial hearing level, age, sex and other clinical parameters were not significantly different between IV steroid and matched oral steroid group. In the treatment outcome, the complete recovery rate in IV steroid and the oral steroid group were 64.7% and 47.1% respectively. Although the recovery rate of the IV steroid group was higher than that of the oral steroid group, statistical significance was not identified. Conclusions：The administration route of systemic steroid did not affect the clinical outcomes of idiopathic sudden sensorineural hearing loss.

참고문헌 (22)

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