HALİL ERDEM ÖZEL, Selahattin GENÇ, FATİH ÖZDOĞAN, Erkan ESEN, Adın SELÇUK

Ani işitme kaybında kanıta dayalı tedavi

Amaç: Ani işitme kaybı, son üç gün içinde gelişen, art arda üç frekansta, 30 dB ve üzerinde olan, nedeni belirsiz sensörinöral işitme kaybı olarak tanımlamıştır. Ani işitme kaybı tedavisi halen bir araştırma konusudur. Kortikostreoidler, hiperbarik oksijen, vazoaktif ajanlar ve antiviral ilaçlar en çok üzerinde durulan tedavi yaklaşımlarıdır. Birçok çalışmaya göre bütün bu seçenekler işitme üzerinde olumlu etkilere sahip görünmektedir, ancak iyileşme düzeyinin klinik önemi açık değildir. Bu çalışmanın amacı literatürün gözden geçirilmesi ve ani işitme kaybı için kanıta dayalı bir tedaviyi oluşturmaktır. Gereç ve yöntem: Ani işitme kaybı tedavisini konu alan güncel yayınlar gözden geçirilmiştir. Sonuç:Çalışmalarda belirtilen tedavi uygulamaları arasındaki farklılıklar ve kombine tedavilerin kullanılması sonuçların yorumunu zorlaştırmaktadır. Bunun için ani işitme kaybı etiyolojisini aydınlatmaya yönelik çalışmaların yanı sıra, spesifik hasta grupları üzerinde yapılmış, tek bir tedavi metodunu plasebo ile karşılaştıran randomize kontrollü çalışmalara ihtiyaç vardır.

Evidence based treatment of sudden hearing loss

Objective: Sudden hearing loss is defined as a sensorineural hearing deficiency that develops rapidly over a maximum of 3 days, a minimum of 30 dB of hearing deficiency at three adjacent frequencies where clinical assessment fails to reveal a cause. Appropriate treatment in sudden hearing loss is still in search. The more common therapeutic approach involves the use of steroids, hyperbaric oxygen, vasoactive substances and antivirals. Based on the most of the studies, all these options seems to have favorable effects on hearing, but the clinical significance of the level of improvement is not clear. The objective of this paper was to review the literature and develop an evidence-based treatment of sudden hearing loss. Methods:Recent studies have been reviewed subject to the treatment of sudden hearing loss. Conclusion: It is difficult to interprete the results because of the variations in the practice of treatments applied and the use of combined treatments in each study. In addition to efforts to clarify the etiology of sudden hearing loss, randomized controlled trials performed on specific patient groups comparing a single type of treatment versus placebo of sudden hearing loss is needed in order to generate an evidence-based treatment protocol for sudden hearing loss.

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