关键词: Corticoide sistémico Intratympanic steroid Mejoría Recovery Recuperación Rescate intratimpánico Response Sensorineural hearing loss Sordera súbita Sordera súbita idiopática Sudden deafness Systemic therapy

Mesh : Acoustic Impedance Tests Adult Anti-Inflammatory Agents / administration & dosage adverse effects therapeutic use Audiometry, Pure-Tone Emergencies Female Follow-Up Studies Hearing Loss, Sensorineural / drug therapy physiopathology Hearing Loss, Sudden / drug therapy physiopathology Humans Injections / adverse effects Male Methylprednisolone / administration & dosage adverse effects therapeutic use Middle Aged Prednisone / administration & dosage adverse effects therapeutic use Pregnenediones / administration & dosage adverse effects therapeutic use Salvage Therapy / methods Tympanic Membrane Tympanic Membrane Perforation / etiology

来  源:   DOI:10.1016/j.otorri.2018.04.009   PDF(Sci-hub)

Abstract:
BACKGROUND: Idiopathic sudden sensorineural hearing loss (ISSHL) is defined as an abrupt hearing loss of at least 30dB of unknown cause. The hearing response obtained after intratympanic steroid injection as a salvage treatment after a prior failure of initial systemic steroid treatment was analysed.
METHODS: An observational study was performed on 125 cases of ISSHL who were diagnosed from 2006 to 2014. Sixteen achieved complete recovery after one week according to Siegel\'s criteria. The remaining 109 cases were analysed in two groups: one that received intratympanic corticosteroid salvage therapy (treatment group) and one that did not (control group). The recovery was analysed after 6 months and 2 years of follow-up.
RESULTS: The difference between each group at baseline were not statistically significant. After systemic treatment for 7 days, PTA in the control group was 53.13dB and 66.11dB in the treatment group (P<.01). After 6 months, the mean PTA improvement was 10.84dB in the treatment group, and 1.13dB in the control group, a significant difference (P<.0001). Only 10 cases achieved full hearing recovery after intratympanic corticosteroid salvage therapy, none of the patients did so in the control group.
CONCLUSIONS: Intratympanic corticosteroid rescue for ISSHL acheived hearing improvement for the cases with failure of initial systemic corticosteroid treatment. However, this treatment did not provide complete hearing recovery according to Siegel\'s criteria in most cases.
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