It's all about timing, early treatment with hyperbaric oxygen therapy and corticosteroids is essential in acute acoustic trauma

IF 1.4 Q2 OTORHINOLARYNGOLOGY
A.B. Bayoumy , R.P. Weenink , E.L. van der Veen , F.S. Besseling-Hansen , A.D.M. Hoedemaeker , F.J.M. de Jong , M.H. van der Laan , R. Swenker , R.A. van Hulst , J.A. de Ru
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引用次数: 1

Abstract

Background

Acute acoustic trauma (AAT) is an acute hearing impairment caused by intense noise-impact. The current management strategy for AAT with substantial hearing loss in the Dutch military is the combination therapy with corticosteroids and hyperbaric oxygen therapy (HBOT). In a previous study, early initiation of the combination therapy was associated with better outcomes. Therefore, we performed a new analysis to assess the difference in hearing outcome between patients in whom combination therapy was started within two days, versus after more than two days.

Methods

A retrospective analysis was performed on military patients diagnosed with AAT with substantial hearing loss who presented between February 2018 and March 2020. Absolute and relative hearing improvement between first and last audiograms were calculated for all affected frequencies (defined as loss of ≥20 dB on initial audiogram). We also determined the amount of patients who recovered to the level of Dutch military requirement, and performed speech discrimination tests.

Results

In this analysis, 30 male patients (49 ears) with AAT were included. The median age was 24.5 years (IQR 23–29). The median time to initiation of therapy with corticosteroids and HBOT were one and two days, respectively. HBOT was started within two days in 31 ears, and after more than two days in 18 ears. The mean absolute and relative hearing gains were 18.8 dB (SD 14.6) and 46.8% (SD 31.3) on all affected frequencies. The 100% discrimination/speech perception level improved from 64.0 dB to 51.7 dB (gain 12.3 dB ± 14.1). There was significantly more improvement in absolute and relative hearing improvement when HBOT was started in ≤2 days, compared to >2 days.

Conclusion

Our analysis shows results in favor of early initiation (≤2 days) of the combination treatment of HBOT and corticosteroids in patients with AAT.

Abstract Image

这一切都是关于时机,早期治疗高压氧治疗和皮质类固醇是至关重要的急性听觉创伤
急性声损伤(acute acoustic injury, AAT)是由强烈的噪声冲击引起的急性听力损伤。在荷兰军队中,AAT合并严重听力损失的当前管理策略是皮质类固醇和高压氧治疗(HBOT)的联合治疗。在先前的一项研究中,早期开始联合治疗与更好的结果相关。因此,我们进行了一项新的分析,以评估在两天内开始联合治疗的患者与两天以上开始联合治疗的患者之间听力结果的差异。方法回顾性分析2018年2月至2020年3月期间出现的严重听力损失的AAT军人患者。计算所有受影响频率(定义为初始听音损失≥20 dB)的第一次和最后一次听音之间的绝对和相对听力改善。我们还确定了恢复到荷兰军队要求水平的患者数量,并进行了语言识别测试。结果纳入男性AAT患者30例(49耳)。中位年龄为24.5岁(IQR 23-29)。皮质类固醇和HBOT开始治疗的中位时间分别为1天和2天。31耳在2天内开始HBOT, 18耳在2天以上开始HBOT。在所有受影响的频率上,平均绝对听力增益和相对听力增益分别为18.8 dB (SD 14.6)和46.8% (SD 31.3)。100%识别/语音感知水平从64.0 dB提高到51.7 dB(增益12.3 dB±14.1)。当HBOT开始≤2天时,绝对和相对听力改善的改善程度明显高于开始≤2天时。结论我们的分析结果支持AAT患者早期(≤2天)开始HBOT和皮质类固醇联合治疗。
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来源期刊
Journal of Otology
Journal of Otology Medicine-Otorhinolaryngology
CiteScore
2.70
自引率
0.00%
发文量
461
审稿时长
18 days
期刊介绍: Journal of Otology is an open access, peer-reviewed journal that publishes research findings from disciplines related to both clinical and basic science aspects of auditory and vestibular system and diseases of the ear. This journal welcomes submissions describing original experimental research that may improve our understanding of the mechanisms underlying problems of basic or clinical significance and treatment of patients with disorders of the auditory and vestibular systems. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines. Journal of Otology welcomes contributions from scholars in all countries and regions across the world.
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