Combination therapy with systemic steroids, an antiviral agent, anticoagulants, and stellate ganglion block for treatment of sudden sensorineural hearing loss.

Korean journal of audiology Pub Date : 2012-09-01 Epub Date: 2012-09-20 DOI:10.7874/kja.2012.16.2.71
Kye Hoon Park, Chi-Kyou Lee, Jong Dae Lee, Moo Kyun Park, Byung Don Lee
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引用次数: 16

Abstract

Background and objectives: Sudden sensorineural hearing loss (SSNHL) is commonly defined as a loss of at least 30 dB in three contiguous frequencies occurring within 3 days. Systemic steroid administration has become the most widely accepted treatment option for SSNHL. Since viral infection and vascular compromise are considered specific causes of SSNHL, antiviral agents, anticoagulants, and stellate ganglion block have been used for its treatment, although the evidence of their effectiveness is weak. The present study evaluated the hearing recovery rate in the combination therapy group (systemic steroids, antiviral agent, anticoagulants, and stellate ganglion block) in comparison with patients treated with systemic steroids alone.

Subjects and methods: A total of 85 patients diagnosed with SSNHL were treated with combination therapy (group A, 46 patients) or systemic steroids only (group B, 39 patients). Hearing improvement was defined as a hearing gain of more than slight improvement using Siegel's criteria. All patients were treated with a 10-day course of systemic steroids (10-mg dexamethasone for 5 days, followed by tapering for 5 days). Acyclovir, heparin, and stellate ganglion block were included in the group A treatment regimen.

Results: The overall rate of hearing improvement was 60.9% (28/46 patients) in group A, which was significantly higher than that (38.5%, 15/39 patients) in group B. The distribution of prognostic factors was not significantly different between the two groups with the exception of the degree of initial hearing loss, which was more severe in group A. Upon analysis according to prognostic factors, group A showed a better hearing improvement recovery rate than group B in patients with hearing loss >70 dB, age >41 years, dizziness, and early treatment (<1 week).

Conclusions: Thus SSNHL patients treated with combination therapy have a higher likelihood of hearing improvement than those treated with systemic steroids alone.

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全身性类固醇、抗病毒药物、抗凝血剂和星状神经节阻滞联合治疗突发性感音神经性听力损失。
背景和目的:突发性感音神经性听力损失(SSNHL)通常定义为3天内连续三个频率至少损失30db。全身类固醇给药已成为SSNHL最广泛接受的治疗选择。由于病毒感染和血管受损被认为是SSNHL的具体原因,抗病毒药物、抗凝血剂和星状神经节阻滞已被用于治疗,尽管其有效性证据不足。本研究评估了联合治疗组(全身性类固醇、抗病毒药物、抗凝血剂和星状神经节阻滞)与单独全身性类固醇治疗患者的听力恢复率。对象和方法:共有85例确诊为SSNHL的患者接受联合治疗(A组,46例)或仅接受全身性类固醇治疗(B组,39例)。使用西格尔标准,听力改善被定义为听力增益大于轻微改善。所有患者均接受10天的全身性类固醇治疗(10毫克地塞米松5天,随后逐渐减量5天)。A组治疗方案为阿昔洛韦、肝素、星状神经节阻滞。结果:A组整体听力改善率为60.9%(28/46例),显著高于B组38.5%(15/39例)。两组预后因素分布无显著差异,除初始听力损失程度A组更为严重外,根据预后因素分析,听力损失>70 dB的患者,A组的听力改善恢复率优于B组。结论:因此,联合治疗的SSNHL患者听力改善的可能性高于单用全身类固醇治疗的患者。
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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