어지럼증이 동반되지 않은 급성 저주파 감각신경성 난청의 고실 내 스테로이드 및 경구 이뇨제 병용 요법
Intratympanic Steroid and Oral Diuretics Combination Therapy for Acute Low Frequency Sensorineural Hearing Loss without Vertigo
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Background and Objectives The effectiveness of intratympanic dexamethasone injections (ITD) alone is compared against the combination therapy of ITD and oral diuretics as treatments for acute low frequency sensorineural hearing loss (LFHL) without vertigo. Subjects and Method A total of 36 patients, with LFHL ≤500 Hz that had been developed within the last 1 month, were enrolled and then were retrospectively categorized into two groups: 1) those treated with ITD four times each day for 4 consecutive days (ITD only group; 19 patients) and 2) those treated with ITD in the same way and diuretics orally for 2 weeks (combination group; 17 patients). After 8 weeks, treatment outcomes were analyzed for LFHL using subjective improvement and audiometric change. Results Hearing thresholds at low frequencies ≤500 Hz were significantly reduced at 8 weeks after treatment in both ITD only and combination group (p＜0.05). The cure rate of the combination group was higher than that of the ITD only group but was not statistically significant (52.9% vs. 42.1%, p＞0.05). For subjective symptoms, there were no statistically significant differences in the improvement rate in either group (combination 58.8% vs. ITD only 63.2%, p＞0.05). In pure tone audiometry, the improvement rate of the combination group was not significantly different from that of the ITD only group (76.5% vs. 73.7%, p＞0.05). There was a significant correlation between the complete recovery rate and duration of symptoms. Conclusion ITD alone is an effective treatment modality for LFHL within 1 month after onset. Diuretics have no additive effect for the recovery of hearing in patients with acute LFHL without vertigo.
Abstract
Background and Objectives The effectiveness of intratympanic dexamethasone injections (ITD) alone is compared against the combination therapy of ITD and oral diuretics as treatments for acute low frequency sensorineural hearing loss (LFHL) without vertigo. Subjects and Method A total of 36 patients, with LFHL ≤500 Hz that had been developed within the last 1 month, were enrolled and then were retrospectively categorized into two groups: 1) those treated with ITD four times each day for 4 consecutive days (ITD only group; 19 patients) and 2) those treated with ITD in the same way and diuretics orally for 2 weeks (combination group; 17 patients). After 8 weeks, treatment outcomes were analyzed for LFHL using subjective improvement and audiometric change. Results Hearing thresholds at low frequencies ≤500 Hz were significantly reduced at 8 weeks after treatment in both ITD only and combination group (p＜0.05). The cure rate of the combination group was higher than that of the ITD only group but was not statistically significant (52.9% vs. 42.1%, p＞0.05). For subjective symptoms, there were no statistically significant differences in the improvement rate in either group (combination 58.8% vs. ITD only 63.2%, p＞0.05). In pure tone audiometry, the improvement rate of the combination group was not significantly different from that of the ITD only group (76.5% vs. 73.7%, p＞0.05). There was a significant correlation between the complete recovery rate and duration of symptoms. Conclusion ITD alone is an effective treatment modality for LFHL within 1 month after onset. Diuretics have no additive effect for the recovery of hearing in patients with acute LFHL without vertigo.
참고문헌 (22)
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