Tr-ENT. 2015; 25(2): 77-81 | DOI: 10.5606/kbbihtisas.2015.65768

Efficacy of multimodality approach to sudden hearing loss

Barýþ Naiboðllu, Semra Külekçi, Mehmet Sürmeli, Ayþegül Verim, Çiðdem Kalaycýk Ertugay, Önder Ihvan, Lütfü Þeneldir, Sema Zer Toros
Department Of Ent, Haydarpasa Numune Education Research Hospital, Istanbul. Turkey

OBJECTIVE: This study aims to investigate whether addition of intratympanic steroid (ITS) to systemic steroid and hyperbaric oxygen (HBO) is effective in the treatment of sudden hearing loss (SHL).
METHODS: Between January 2008 and October 2011, 58 patients diagnosed with SHL were enrolled in the study. Twenty patients (11 males, 9 females; mean age 45.3±21 years; range 24 to 66 years) who received systemic steroid and HBO composed group 1, while 38 patients (19 males, 19 females; mean age 41.6±16 years; range 25 to 61 years) who received ITS in addition to systemic steroid and HBO composed group 2.
RESULTS: Post-treatment hearing improvement was statistically significant in both groups in terms of the mean pure tone according to the Siegel’s criteria (p<0.05). Treatment was successful at 55% of patients in group 1 and 63% in group 2. Despite increased success rate with the addition of ITS, it did not indicate statistical significance (p>0.05). However, there was a strong statistically significant difference in terms of profound hearing loss over 90 dB (p<0.05). None of six patients (0%) with profound hearing loss in group 1 benefited treatment, while addition of ITS to the treatment yielded success in six of 12 patients with profound hearing loss (50%) in group 2 (p<0.05).
CONCLUSION: Addition of ITS to systemic steroid and HBO treatment may yield better results in patients with SHL. However, ITS injection seems beneficial for patients with profound SHL.

Keywords: Hyperbaric oxygen, intratympanic steroid; sudden sensorineural hearing loss.

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Ani iþitme kaybýnda çoklu tedavi yaklaþýmýn etkinliði

Barýþ Naiboðllu, Semra Külekçi, Mehmet Sürmeli, Ayþegül Verim, Çiðdem Kalaycýk Ertugay, Önder Ihvan, Lütfü Þeneldir, Sema Zer Toros
Haydarpaþa Numune Eðitim Araþtýrma Hastanesi, Kbb Kliniði Istanbul

AMAÇ: Bu çalýþmada ani iþitme kaybýnýn (AÝK) tedavisinde sistemik steroid ve hiperbarik oksijene (HBO) ilave olarak intratimpanik steroidin (ITS) etkinliði araþtýrýldý.
YÖNTEMLER: Ocak 2008 - Ekim 2011 tarihleri arasýnda AÝK tanýsý konulan 58 hasta çalýþmaya dahil edildi. Sistemik steroid ve HBO tedavisi uygulanan 20 hasta (11 erkek, 9 kadýn; ort. yaþ 45.3±21 yýl; daðýlým 24-66 yýl) grup 1’i oluþtururken; sistemik steroid ve HBO tedavisine ek olarak ITS tedavisi uygulanan 38 hasta (19 erkek, 19 kadýn; ort. yaþ 41.6±16 yýl; daðýlým 25-61 yýl) grup 2’yi oluþturdu.
BULGULAR: Tedavi sonrasý iyileþme oranlarý, Siegel kriterlerine göre saf ses ortalamalarýnda her iki grup arasýnda istatistiksel olarak anlamlý bulundu (p<0.05). Tedavi baþarýsý grup 1’de %55, Grup 2’de %63 idi. Baþarý oranlarýnda ITS ilave edilmesiyle bir artýþ olmasýna raðmen, bu istatistiksel olarak anlamlý deðildi (p>0.05). Ancak 90 dB üzeri derin iþitme kayýplarýnda güçlü bir istasitiksel fark vardý (p<0.05). Grup 1’de derin iþitme kaybý olan altý hastanýn hiçbiri (%0) tedaviden yarar görmezken, tedaviye ITS eklenen grup 2’de derin iþitme kaybý olan 12 hastanýn altýsýnda (%50) baþarý saðlandý (p<0.05).
SONUÇ: Ýntratimpanik steroidin sistemik steroid ve HBO tedavisine ilavesi, AÝK olan hastalarda daha iyi sonuçlar verebilir. Ancak, ITS enjeksiyonu derin AÝK olan hastalar için yararlý görünmektedir.

Anahtar Kelimeler: Hiperbarik oksijen, intratimpanik steroid; ani sensörinöral iþitme kaybý.

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