Ani idiyopatik İşitme Kayıplarında Kombine Steroid Tedavisinin Etkinliği Prognostik Faktörlerle İlişkisi
Öz
Amaç:Çalışmamızda Ani idiopatik sensorinöral işitme kaybı (AİK) olanlarda belirlediğimiz prognostik faktörlerin ve kombine tedavilerin, intratimpanik steroid enjeksiyonu sonrası işitmedeki düzelme üzerine etkilerini araştırdık.
Gereç ve yöntemler:2018-2019 yılları arasında Kahramanmaraş Sütçü İmam Üniversitesi Kulak Burun Boğaz kliniğinde AİK sebebiyle ayaktan veya yatarak tedavi alan, başka sağlık kuruluşunda tedavi almamış ve işitme kaybının başlangıcı ile tedaviye başlama arasında geçen süre 3 haftadan kısa olan 30 hasta retrospektif olarak incelendi.
Bulgular:Çalışmaya 17 kadın 13 erkek olmak üzere 30 hasta dahil edildi. Hastaların yaş ortalaması 46 idi.Hastaların iyileşme düzeyleri Siegel kriterlerine göre değerlendirildi ve %30’unda (n=9) tip 1 (tam düzelme), %10’unda (n=3) tip 2 (belirgin düzelme), %10’unda (n=3) tip 3 (hafif düzelme) ve %50’sinde (n=15) tip 4 (düzelme yok) olarak kaydedildi. Çalışmamıza dahil edilen komorbid faktörler arasında, diğer faktörlerin iyileşme üzerine anlamlı etkisi yoktu (p>0,05). Buna ek olarak intratimpanik steroid enjeksiyonu ile kombine olarak verilen tedaviler arasında da işitme kazanımları açısından istatistiksel olarak anlamlı bir fark bulunmadı. Hasta grubumuzdaki öykü süreleri bir gün ile yirmibir gün arasında değişmekteydi ve çalışmamızda şikayet ile tedaviye başlama arasında geçen süre beş günden kısa olanlarda iyileşme anlamlı bulundu (p<0,05).
Sonuç: Ani işitme kaybı; acil tanı konulup acil tedavi edilmesi gereken bir durumdur. Tedavi edilmediğinde kalıcı işitme kayıplarına, bireyin psikolojik, bilişsel, sosyal gelişimi üzerine olumsuz etkilere sebep olabilir. Çalışmamızda yalnızca intratimpaniksteroid tedavisi ve kombine tedavilerin birbirine üstünlük göstermediği bulundu.
Anahtar Kelimeler
Destekleyen Kurum
yok
Proje Numarası
yok
Teşekkür
Odyometrik incelemeleri yapan odyoloji biriminde çalışan odyometrist teknikeri Kenan Turna, odyometrist teknikeri Büşra Üçgöz’ e teşekkür ederiz.
Kaynakça
- 1. NationalInstitute on DeafnessandOtherCommunicationDisorders. NIDCD FactSheet: SuddenDeafness. Washington, DC: US Department of Healthand Human Services; 2018.
- 2. O'Malley MR, Haynes DS. Suddenhearingloss. OtolaryngolClin North Am2008;41:633- 49.
- 3. Çelik O, Gök Ü, Yalçın S, Yanık H, Hançer A, Kaygusuz S ve ark. Ani işitme kayıplı hastalarımızın retrospektif analizi. KBB İhtisas Dergisi 1997;4(1):39-42.
- 4. İnanlı S, Polat Ş, Tutkun A, Batman Ç, Üneri C, Şehitoğlu MA. Ani işitme kayıplı olgularımızda tedavi ve prognozun retrospektif analizi. Türk Otolaringoloji Arşivi 2002;40(3):196-200.
- 5. Kaplan Y, Ülkümen B, Kanlıkama M. Ani işitme kaybında prognostik faktörlerin değerlendirilmesi. J Kartal TR 2012;23:84-90.
- 6. Moskowitz D, Lee KJ, Smith HW. Steroid use in idiopathic sudden sensorineural hearing loss. Laryngoscope 1984;94(5 ):664-6
- 7. Siegel LG. The Treatment of Idiopathic Sudden Sensorineural Hearing Loss. Otolaryngol Clin North Am. 1975; 8:467-473. 8. Tezer MS, Baran Y,Erdur Ö, et al. Comparison of systemic, Intratympanic and Combination Therapy of the steroids for the treatment of sudden sensorineural hearing loss. Turkiye Klinikleri J Med Sci 2013;33(2):353-9 9. Park HM, Jung SW, Rhee CK. Vestibular diagnosis as prognostic indicator in sudden hearing loss with vertigo. Acta Otolaryngol Suppl 2001;545:80-3.
- 10. Parnes LS, Sun AH, Freeman DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope. 1999;109:1–17.
- 11. Kang WS, Yang CJ, Shim M, et al. Prognostic factors for recovery from sudden sensorineural hearing loss: a retrospective study. J Audiol Otol. 2017;21:9–15.
- 12. Chou Y-F, Chen P-R, Kuo I-J, et al. Comparison of intermittent intratympanic steroid injection and near-continual transtympanic steroid perfusion as salvage treatments for sudden sensorineural hearing loss. Laryngoscope. 2013;123:2264–2269.
- 13. Stachler RJ, Chandrasekhar SS, Archer SM, et al. Clinical practice guideline: Sudden hearing loss. Otolaryngol Head Neck Surg 2012;146:S1–35.
- 14. Edizer DT, Çelebi Ö, Hamit B, et al. Recovery of idiopathic sudden sensorineural hearing loss. J Int Adv Otol2015;11:122-6.
- 15. Wu HP, Chou YF, Yu SH, Wang CP, Hsu CJ, Chen PR. Intratympanic steroid injections as a salvage treatment for sudden sensorineural hearing loss: A randomized, double-blind, placebocontrolled study. Otol Neurotol 2011;32:774–9.
- 16. Kaplan Y, Ülkümen B, Kanlıkama M. Evaluation of prognos¬tic factors in sudden hearing loss. J Kartal TR 2012; 23: 84-90.
- 17. Attanasio G, Covelli E, Cagnoni L, et al. Does age influence the success of intra-tympanic steroid treatment in idiopathic sudden deafness? Acta Otolaryngol. 2015;135:969–973.
- 18. Battaglia A, Lualhati A, Lin H, et al. A prospective multi-centered study of the treatment of idiopathic sudden sensorineural hearing loss with combination therapy versus high-dose prednisone alone: a 139 patient follow-up. Otol Neurotol. 2014;35: 1091–1098.
- 19.Rauch SD. Intratympanic steroids for sensorineural hearing loss. Otolaryngol Clin North Am. 2004;37:1061–1074.
- 20. Han X, Yin X, Du X, Sun C. Combined intratympanic and systemic use of steroids as a first-line treatment for sudden sensorineural hearing loss: a meta-analysis of randomized, controlled trials. Otol Neurotol. 2017;38:487–495.
- 21. Ashtiai MK, Firouzi F, Bastaninejad S, et al. Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: a randomized controlled trial. Eur Arch Otorhinolaryngol 2017.
- 22. Naiboğllu B, Külekçi S, Sürmeli M, Verim A, Kalaycik Ertugay Ç, İhvan Ö, et al. Efficacy of multimodality approach to sudden hearing loss. Kulak Burun Bogaz Ihtis Derg2015;25:77 81.
The Effectiveness of Combined Steroid Therapy in Sudden Idiopathic Hearing Loss and Its Relationship with Prognostic Factors
Öz
Introduction: In our study, we investigated the effects of prognostic factors and combined therapies that we determined in patients with sudden hearing loss on hearing improvement after intratympanic steroid injection.
Material Method: Between 2018 and 2019, 30 patients were examined retrospectively who received outpatient or inpatient treatment for Idiopathic sudden sensorineural hearing loss (ISSNHL) in KahramanmarasSutcu Imam University Ear Nose and Throat clinic and did not receive treatment in another healthcare institution and the period between the onset of hearing loss and starting treatment was less than 3 weeks.
Results: 30 patients, 17 female and 13 male, were included in our study. The average age of the patients was 46. Recovery levels of patients were evaluated according to Siegel criteria and type 1 (complete improvement) in 30% (n = 9), type 2 (significant improvement) in 10% (n = 3), type 3 (mild improvement) in 10% (n = 3) and 50% (n = 15) were recorded as type 4 (no improvement). Among the comorbid factors included in our study, while other factors had no significant effect on recovery (p> 0.05). In addition, there was no statistically significant difference in terms of hearing gains between treatments given in combination with intratympanic steroid injection. The duration of the history of outpatient group ranged from one day to twenty-one days, and in our study, improvement was found to be significant in those with less than five days between complaints and starting treatment (p <0.05).
Conclusion: Sudden hearing loss is a disease that requires immediate diagnosis and treatment. If left untreated, this can lead to permanent hearing loss and negative effects on the patient's psychological, cognitive, and social development. In our study, it was understood that only intratympanic steroid treatment and combined therapies did not show superiority to each other.
Anahtar Kelimeler
Proje Numarası
yok
Kaynakça
- 1. NationalInstitute on DeafnessandOtherCommunicationDisorders. NIDCD FactSheet: SuddenDeafness. Washington, DC: US Department of Healthand Human Services; 2018.
- 2. O'Malley MR, Haynes DS. Suddenhearingloss. OtolaryngolClin North Am2008;41:633- 49.
- 3. Çelik O, Gök Ü, Yalçın S, Yanık H, Hançer A, Kaygusuz S ve ark. Ani işitme kayıplı hastalarımızın retrospektif analizi. KBB İhtisas Dergisi 1997;4(1):39-42.
- 4. İnanlı S, Polat Ş, Tutkun A, Batman Ç, Üneri C, Şehitoğlu MA. Ani işitme kayıplı olgularımızda tedavi ve prognozun retrospektif analizi. Türk Otolaringoloji Arşivi 2002;40(3):196-200.
- 5. Kaplan Y, Ülkümen B, Kanlıkama M. Ani işitme kaybında prognostik faktörlerin değerlendirilmesi. J Kartal TR 2012;23:84-90.
- 6. Moskowitz D, Lee KJ, Smith HW. Steroid use in idiopathic sudden sensorineural hearing loss. Laryngoscope 1984;94(5 ):664-6
- 7. Siegel LG. The Treatment of Idiopathic Sudden Sensorineural Hearing Loss. Otolaryngol Clin North Am. 1975; 8:467-473. 8. Tezer MS, Baran Y,Erdur Ö, et al. Comparison of systemic, Intratympanic and Combination Therapy of the steroids for the treatment of sudden sensorineural hearing loss. Turkiye Klinikleri J Med Sci 2013;33(2):353-9 9. Park HM, Jung SW, Rhee CK. Vestibular diagnosis as prognostic indicator in sudden hearing loss with vertigo. Acta Otolaryngol Suppl 2001;545:80-3.
- 10. Parnes LS, Sun AH, Freeman DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope. 1999;109:1–17.
- 11. Kang WS, Yang CJ, Shim M, et al. Prognostic factors for recovery from sudden sensorineural hearing loss: a retrospective study. J Audiol Otol. 2017;21:9–15.
- 12. Chou Y-F, Chen P-R, Kuo I-J, et al. Comparison of intermittent intratympanic steroid injection and near-continual transtympanic steroid perfusion as salvage treatments for sudden sensorineural hearing loss. Laryngoscope. 2013;123:2264–2269.
- 13. Stachler RJ, Chandrasekhar SS, Archer SM, et al. Clinical practice guideline: Sudden hearing loss. Otolaryngol Head Neck Surg 2012;146:S1–35.
- 14. Edizer DT, Çelebi Ö, Hamit B, et al. Recovery of idiopathic sudden sensorineural hearing loss. J Int Adv Otol2015;11:122-6.
- 15. Wu HP, Chou YF, Yu SH, Wang CP, Hsu CJ, Chen PR. Intratympanic steroid injections as a salvage treatment for sudden sensorineural hearing loss: A randomized, double-blind, placebocontrolled study. Otol Neurotol 2011;32:774–9.
- 16. Kaplan Y, Ülkümen B, Kanlıkama M. Evaluation of prognos¬tic factors in sudden hearing loss. J Kartal TR 2012; 23: 84-90.
- 17. Attanasio G, Covelli E, Cagnoni L, et al. Does age influence the success of intra-tympanic steroid treatment in idiopathic sudden deafness? Acta Otolaryngol. 2015;135:969–973.
- 18. Battaglia A, Lualhati A, Lin H, et al. A prospective multi-centered study of the treatment of idiopathic sudden sensorineural hearing loss with combination therapy versus high-dose prednisone alone: a 139 patient follow-up. Otol Neurotol. 2014;35: 1091–1098.
- 19.Rauch SD. Intratympanic steroids for sensorineural hearing loss. Otolaryngol Clin North Am. 2004;37:1061–1074.
- 20. Han X, Yin X, Du X, Sun C. Combined intratympanic and systemic use of steroids as a first-line treatment for sudden sensorineural hearing loss: a meta-analysis of randomized, controlled trials. Otol Neurotol. 2017;38:487–495.
- 21. Ashtiai MK, Firouzi F, Bastaninejad S, et al. Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: a randomized controlled trial. Eur Arch Otorhinolaryngol 2017.
- 22. Naiboğllu B, Külekçi S, Sürmeli M, Verim A, Kalaycik Ertugay Ç, İhvan Ö, et al. Efficacy of multimodality approach to sudden hearing loss. Kulak Burun Bogaz Ihtis Derg2015;25:77 81.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Proje Numarası | yok |
| Yayımlanma Tarihi | 21 Mart 2022 |
| Gönderilme Tarihi | 25 Ocak 2021 |
| Kabul Tarihi | 9 Şubat 2021 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 17 Sayı: 1 |
