Murat Gümüşsoy, İlker Burak Arslan, İbrahim Çukurova

İdiopatik ani işitme kaybında intratimpanik steroid uygulaması ile klasik tedavi etkinliğinin karşılaştırılması

Amaç: Ani işitme kaybı, nedeni bilinmeyen, üç gün içerisinde veya daha kısa zamanda aniden ortaya çıkan, birbirini takip eden üç frekansı tutan, 30 dB ve üzerindeki sinirsel tipte işitme kaybıdır. Bu çalışmadaki amacımız, intratimpanik steroid tedavisi ile birlikte klasik tedavi birlikteliğinin idiopatik ani işitme kaybı tedavisinde etkinliğini değerlendirmektir. Yöntem: Şubat 2010 – Haziran 2012 tarihleri arasında kliniğimizde idiopatik ani işitme kaybı tanısı alan 140 hasta çalışmaya alınarak iki gruba ayrıldı. İntratimpanik steroid tedavisi ve klasik ani işitme kaybı tedavisi alan 76 hasta [37’si kadın (%48.68), 39’u erkek (%51.32); yaş ortalaması 45.1±14.16] ile sadece klasik tedavi kombinasyonu uygulanan 64 hasta [34’ü kadın (%53.18), 30’u erkek (%46.82); yaş ortalaması 47.6±17.74] çalışmaya dahil edildi. Tedaviden 1 ay sonra hastaların saf ses ortalamaları ve konuşmayı ayırt etme skoru, tedavi öncesindeki saf ses ortalamaları ve konuşmayı ayırt etme skoru ile karşılaştırıldı. Bulgular: Tedavi öncesi saf ses ortalaması, intratimpanik steroid tedavi grubunda 68.28 dB, diğer grupta 67.21 dB olarak bulundu ve istatistiksel olarak aralarında fark yoktu. Tedavi sonrasında 1. ay kontrolünde saf ses ortalaması, intratimpanik steroid tedavi grubunda 33.52 dB, klasik tedavi grubunda 44.46 dB olarak bulundu ve istatistiksel olarak aralarındaki fark anlamlıydı. İntratimpanik steroid tedavi grubunda kazanç 34.76 dB’e yükselirken, klasik tedavi grubunda fark 22.75 dB olarak ölçüldü ve bu sonuç istatistiksel olarak anlamlı bulundu (p < 0.05). Sonuç: İdiopatik ani işitme kaybı tedavisinde, klasik ani işitme kaybı tedavi protokolü ile kombine edilen intratimpanik steriod uygulaması, işitme kazancı yönünden sadece klasik kombine tedavi alan hastalara kıyasla anlamlı sonuçlar vermektedir.

Anahtar Kelimeler:

Ani işitme kaybı, sensorinöral işitme kaybı, intratimpanik steroid

Comparative efficacies of intratympanic steroid administration and classic therapy in the management of idiopathic sudden sensorineural hearing loss

Objective: Sudden hearing loss is a sensorineural hearing loss with an unknown etiology at ≥30 dB which appears in 3 days or within a shorter period of time and obstructs three successive frequencies. Our objective in this study is to assess the effectiveness of the combination of classic therapy and intratympanic steroid treatment in the management of idiopathic sudden sensorineural hearing loss. Methods: One hundred and forty patients diagnosed with idiopathic sudden sensorineural hearing loss in our clinics between February 2010 and June 2012 were separated into 2 groups. Seventy-six patients [37 women (48.68%) and 39 men (51.32%)] with a mean age of 45.1±14.16 years managed with a combination of classic sudden hearing loss and intratympanic steroid treatment (Group 1) and 64 patients [34 women (53.18%) and 30 men (46.82%)] with a mean age of 47.6±17.74 years managed with only classic sudden hearing loss treatment (Group 2) were included in the study. One month after the study, pure-tone averages and speech discrimination scores of the patients were compared with those obtained 1 month before the treatment. Results: Pure-tone average of the intratympanic-steroid treatment group was found to be 68.28 dB before the treatment where in the other group it was 67.21 dB without any statistically significant difference between groups. When followed-up 1 month after the therapy, pure-tone average was found to be 33.52 dB in the intratympanic steroid treatment group and 44.46 dB in the classic therapy group with a statistically significant intergroup difference. Gain was up to 34.76 dB in the intratympanic steroid treatment group whereas in the classic therapy group, the difference was 22.75 dB which was found to be statistically significant (p

Keywords:

Sudden hearing loss, sensorineural hearing loss, intratympanic steroid,

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Please cite this article as: Gümüﬂsoy M, Arslan ‹B, Çukurova ‹. Comparative efficacies of intratympanic steroid administration and classic therapy in
the management of idiopathic sudden sensorineural hearing loss. J Med Updates 2013;3(2):51-55.