Intratympanic steroid injection for treating sudden sensorineural hearing loss in patients with hepatitis B virus infection

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology Pub Date : 2025-04-26 DOI:10.1016/j.amjoto.2025.104660

Shih-Lung Chen , Chia-Ying Ho , Shy-Chyi Chin , Kai-Chieh Chan , Yu-Chien Wang

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引用次数: 0

Abstract

Background

Sudden sensorineural hearing loss (SSNHL) is an acute auditory disorder commonly treated with steroids. However, the prognostic factors for patients with hepatitis B virus (HBV) undergoing intra-tympanic steroid injections (ITSIs) remain unclear. This research seeks to explore the prognostic factors affecting the outcome of ITSI treatment in HBV patients with unilateral SSNHL.

Methods

This retrospective study included 77 patients with HBV who presented with unilateral SSNHL from October 2018 to October 2024. All patients underwent ITSIs, and their clinical and audiological data were thoroughly analyzed.

Results

The mean age of the patients was 48.61 ± 15.98 years. Following ITSIs, the mean gain in hearing level was 15.51 ± 19.22 dB, the mean gain in speech reception threshold (SRT) was 16.23 ± 31.02 dB, and the mean gain in speech discrimination score (SDS) was 17.55 ± 30.69 %. According to Siegel’s criteria, 6 patients (7.79 %) achieved complete recovery, 13 (16.88 %) experienced partial recovery, 33 (42.86 %) had slight recovery, and 25 (32.47 %) showed no improvement.

In univariate analyses, factors such as age ≥ 50 years (odds ratio [OR] = 0.3257, 95 % confidence interval [CI]: 0.1085–0.9781, p = 0.0391), the presence of vertigo (OR = 0.2656, 95 % CI: 0.0696–1.0137, p = 0.0335), and profound hearing loss as measured by pure-tone audiometry (PTA; OR = 0.0638, 95 % CI: 0.0080–0.5099, p = 0.0003) were identified as adverse prognostic factors. In the multivariate analysis, age ≥ 50 years (OR = 0.2799, 95 % CI: 0.0830–0.9437, p = 0.0400) and profound hearing loss (OR = 0.0609, 95 % CI: 0.0072–0.5133, p = 0.0101) emerged as independent negative prognostic factors.

Conclusions

ITSIs are effective in managing SSNHL in patients with HBV while minimizing the side effects associated with high-dose systemic steroids. Among the 77 HBV patients with SSNHL who received ITSI, age ≥ 50 years and profound hearing loss were identified as negative prognostic factors. For HBV patients with these risk factors, timely and proactive treatment is essential.

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鼓室内注射类固醇治疗乙型肝炎病毒感染患者突发性感音神经性听力损失

背景：突发性感音神经性听力损失（SSNHL）是一种常用类固醇治疗的急性听觉障碍。然而，乙型肝炎病毒（HBV）患者接受鼓室内类固醇注射（ITSIs）的预后因素仍不清楚。本研究旨在探讨影响单侧SSNHL患者ITSI治疗结果的预后因素。方法回顾性研究纳入2018年10月至2024年10月期间出现单侧SSNHL的77例HBV患者。所有患者均接受itsi治疗，并对其临床和听力学资料进行全面分析。结果患者平均年龄48.61±15.98岁。itsi后，听力水平平均增益为15.51±19.22 dB，言语接收阈值（SRT）平均增益为16.23±31.02 dB，言语辨别评分（SDS）平均增益为17.55±30.69%。根据Siegel标准，完全恢复6例（7.79%），部分恢复13例（16.88%），轻微恢复33例（42.86%），无好转25例（32.47%）。在单因素分析中，年龄≥50岁（优势比[OR] = 0.3257, 95%可信区间[CI]: 0.1085-0.9781, p = 0.0391）、是否存在眩晕（OR = 0.2656, 95% CI: 0.0696-1.0137, p = 0.0335）以及纯音听力学测量的深度听力损失(PTA；OR = 0.0638, 95% CI: 0.0080-0.5099, p = 0.0003)被确定为不良预后因素。在多因素分析中，年龄≥50岁（OR = 0.2799, 95% CI: 0.0830-0.9437, p = 0.0400）和重度听力损失（OR = 0.0609, 95% CI: 0.0072-0.5133, p = 0.0101）成为独立的不良预后因素。结论sitsi可有效治疗HBV患者的SSNHL，同时最大限度地减少与大剂量全身类固醇相关的副作用。在接受ITSI治疗的77例SSNHL HBV患者中，年龄≥50岁和重度听力损失被确定为不良预后因素。对于具有这些危险因素的HBV患者，及时和积极的治疗至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Otolaryngology 医学-耳鼻喉科学

CiteScore

4.40

自引率

4.00%

发文量

378

审稿时长

41 days

期刊介绍： Be fully informed about developments in otology, neurotology, audiology, rhinology, allergy, laryngology, speech science, bronchoesophagology, facial plastic surgery, and head and neck surgery. Featured sections include original contributions, grand rounds, current reviews, case reports and socioeconomics.