노인 돌발성 난청 환자의 임상적 특징 및 예후인자에 대한 분석
Clinical Characteristics and Prognosis of Idiopathic Sudden Sensorineural Hearing Loss in Old Age
0
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background and Objectives In aging society, interest in idiopathic sudden sensorineural hearing loss (ISSNHL) in elderly have been increased. However, as there has been little discussion about prognostic factors of ISSNHL in old age, this study aims to investigate clinical factors related with prognosis of ISSNHL in elderly and compare with that in adults. Subjects and Method A retrospective medical chart review was performed in patients over 19 years old who diagnosed with ISSNHL from Jan. 2010 to Dec. 2012. Patients were categorized into the old age group (over 65 years old, n=62) and the control group (aged 19 to 64 years old, n=218). Clinical findings, audiological result and treatment outcomes were compared between two groups. And possible prognostic factors of SSNHL in elderly were also investigated. Results Significant difference of hearing recovery was identified between the old age group (33.9%, 21/62) and control group (50.9%, 111/218) according to Siegel’s criteria (p=0.021). Multivariate analysis concluded that delayed treatment and low speech discrimination score (SDS) might lead to poor prognosis in elderly. The presence of tinnitus or dizziness, audiometric configurations, hypertension and diabetes mellitus did not affect the treatment results of ISSNHL in the old age group. Conclusion Onset of treatment and initial SDS could be possible prognostic factors of ISSNHL in elderly. Early diagnosis and urgent treatment are more important in old age. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(8):511-7
Abstract
Background and Objectives In aging society, interest in idiopathic sudden sensorineural hearing loss (ISSNHL) in elderly have been increased. However, as there has been little discussion about prognostic factors of ISSNHL in old age, this study aims to investigate clinical factors related with prognosis of ISSNHL in elderly and compare with that in adults. Subjects and Method A retrospective medical chart review was performed in patients over 19 years old who diagnosed with ISSNHL from Jan. 2010 to Dec. 2012. Patients were categorized into the old age group (over 65 years old, n=62) and the control group (aged 19 to 64 years old, n=218). Clinical findings, audiological result and treatment outcomes were compared between two groups. And possible prognostic factors of SSNHL in elderly were also investigated. Results Significant difference of hearing recovery was identified between the old age group (33.9%, 21/62) and control group (50.9%, 111/218) according to Siegel’s criteria (p=0.021). Multivariate analysis concluded that delayed treatment and low speech discrimination score (SDS) might lead to poor prognosis in elderly. The presence of tinnitus or dizziness, audiometric configurations, hypertension and diabetes mellitus did not affect the treatment results of ISSNHL in the old age group. Conclusion Onset of treatment and initial SDS could be possible prognostic factors of ISSNHL in elderly. Early diagnosis and urgent treatment are more important in old age. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(8):511-7
참고문헌 (25)
- Chau JK, "Systematic review of the evidence for the etiology of adult sudden sensorineural hearing loss", Laryngoscope, 120(5), pp.1011~1021 (2010)
- Chon KM, "Clinical practice of sudden hearing loss" (1995), Jung Myung Dang Co
- Mattox DE, "Natural history of sudden sensorineural hearing loss", Ann Otol Rhinol Laryngol, 86(4 PT 1), pp.463~480 (1977)
- Conlin AE, "Treatment of sudden sensorineural hearing loss: II. A Meta-analysis", Arch Otolaryngol Head Neck Surg, 133(6), pp.582~586 (2007)
- Byl FM Jr, "Sudden hearing loss: eight years’ experience and suggested prognostic table", Laryngoscope, 94(5 PT 1), pp.647~661 (1984)
- Mattox DE, "Idiopathic sudden sensorineural hearing loss", Am J Otol, 10(3), pp.242~247 (1989)
- Siegel LG, "The treatment of idiopathic sudden sensorineural hearing loss", Otolaryngol Clin North Am, 8(2), pp.467~473 (1975)
- 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)
- Schuknecht HF, "The pathology of idiopathic sudden sensorineural hearing loss", Arch Otorhinolaryngol, 243(1), pp.1~15 (1986)
- Shaia FT, "Sudden sensori-neural hearing impairment: a report of 1,220 cases", Laryngoscope, 86(3), pp.389~398 (1976)
- Toubi E, "Immune-mediated disorders associated with idiopathic sudden sensorineural hearing loss", Ann Otol Rhinol Laryngol, 113(6), pp.445~449 (2004)
- Hirano K, "Prognosis of sudden deafness with special reference to risk factors of microvascular pathology", Auris Nasus Larynx, 26(2), pp.111~115 (1999)
- Alexander TH, "Incidence of sudden sensorineural hearing loss", Otol Neurotol, 34(9), pp.1586~1589 (2013)
- Nagaoka J, "Idiopathic sudden sensorineural hearing loss: evolution in the presence of hypertension, diabetes mellitus and dyslipidemias", Braz J Otorhinolaryngol, 76(3), pp.363~369 (2010)
- Ballesteros F, "Idiopathic sudden sensorineural hearing loss: classic cardiovascular and new genetic risk factors", Audiol Neurootol, 7(6), pp.400~408 (2012)
- 전경명, "노인의 돌발성 난청", 대한이비인후과학회지 두경부외과학, 47(7), pp.626~631 (2004), 대한이비인후과학회
- Samim E, "Combined treatment of sudden sensorineural hearing loss with steroid, dextran and piracetam: experience with 68 cases", Eur Arch Otorhinolaryngol, 261(4), pp.187~190 (2004)
- 박용수, "돌발성 난청 환자에서 고실 내 스테로이드 주입의 효과", 대한이비인후과학회지 두경부외과학, 45(12), pp.1136~1140 (2002), 대한이비인후과학회
- Koltsidopoulos P, "Intratympanic and systemic steroids for sudden hearing loss", Otol Neurotol, 34(4), pp.771~776 (2013)
- Lim HJ, "Efficacy of 3 different steroid treatments for sudden sensorineural hearing loss: a prospective, randomized trial", Otolaryngol Head Neck Surg, 148(1), pp.121~127 (2013)
- Furuhashi A, "Sudden deafness:long-term follow-up and recurrence", Clin Otolaryngol Allied Sci, 27(6), pp.458~463 (2002)
- Jun HJ, "Analysis of frequency loss as a prognostic factor in idiopathic sensorineural hearing loss", Acta Otolaryngol, 132(6), pp.590~596 (2012)
- Oh JH, "The clinical characteristics and treatment results of bilateral sudden sensorineural hearing loss", Korean J Otolaryngol-Head Neck Surg, 48(7), pp.848~853 (2005)
- Lionello M, "Uni- and multivariate models for investigating potential prognostic factors in idiopathic sudden sensorineural hearing loss", Eur Arch Otorhinolaryngol (2014)
- Nosrati-Zarenoe R, "Corticosteroid treatment of idiopathic sudden sensorineural hearing loss: randomized triple-blind placebo-controlled trial", Otol Neurotol, 33(4), pp.523~531 (2012)