Çocuklarda Ani İşitme Kaybında Hiperbarik Oksijen Tedavisinin Yeri

Amaç: Ani Sensörinöral İşitme Kaybı (ASNIK) otolojik bir acil durumdur. Kalıcı ASNIK, çocuk hastaların sosyal yaşamını, psikolojisini ve dil gelişimini ciddi şekilde etkileyebilir. ASNIK tedavisi konusunda fikir birliği yoktur. ASNIK tanısı ile sistemik steroid tedavisine ek olarak hiperbarik oksijen tedavisi (HBOT) alan çocuk hastalarda etiyoloji, prognostik faktörler ve tedavi sonuçları karşılaştırıldı. Gereç ve Yöntemler: ASNIK tanısı ile HBOT uygulanan 8-18 yaşları arasında en az üç ay takip edilen 15 çocuğun dosyaları geriye dönük olarak incelendi.Bulgular: ASNIK’li hastaların yaşları 8 ile 18 yaş arasındaydı (ortalama 14.47±3.31 yıl). Yedi (% 46.7) hastada tam iyileşme, iki (%13.3) hastada kısmi iyileşme, iki (% 13.3) hastada hafif iyileşme, dört (% 26.7) hastada düzelme olmadı. Hastaların tedavi öncesi Saf Ses Ortalamaları (SSO) 28 ile 109 dB HL (ortalama±ss; 57.3±26.2 dB HL) arasında değişirken, tedavi sonrası PTA’ları 6 ile 88 dB HL (38±27.3 dB HL), (p=0.002 ). Yaş, cinsiyet, HBOT seans sayısı ve tedaviye yanıt arasında anlamlı bir fark bulunmadı (sırasıyla p = 0.581, p = 0.904, p = 0.357, p = 0.184). Sonuç: Hiperbarik oksijen tedavisi, pediatrik SSNHL hastaları için güvenli ve iyi tolere edilen bir tedavi yöntemidir. Etik ve yasal sorunlara yol açmamak için ASNIK tanısı alan çocuk hastaların ailelerinin onayı ile tedaviye başlanması gerektiğini düşünüyoruz.

Anahtar Kelimeler:

Ani İşitme Kaybı, prognoz, çocuk, ergen, hiperbarik oksijen tedavisi

The Role of Hyperbaric Oxygen Therapy in Sudden Sensorineural Hearing Loss in Children

Objective: Sudden Sensorineural Hearing Loss (SSNHL) is an otological emergency. Permanent SSNHL can seriously affect the social life, psychology, and language development of pediatric patients. There is no consensus the treatment of SSNHL. We compared the etiology, prognostic factors, and treatment results in pediatric patients who received hyperbaric oxygen therapy (HBOT) in addition to systemic steroid therapy with a diagnosis of SSNHL. Material and Methods: The files of 15 children were received HBOT with the diagnosis of SSNHL, between the ages of 8-18 years, and followed-up at least three months were retrospectively analyzed. Results: The ages of patients with SSNHL ranged from 8 to 18 years of age (mean 14.47±3.31 years). Seven (46.7%) patients had complete recovery, and two (13.3%) patients had partial recovery, two (13.3%) patients had slight recovery, four (26.7%) patients had no improvement. While pre-treatment PTAs of the patients were ranged between 28 to 109 dB HL (mean±sd; 57.3±26.2 dB HL), post-treatment PTAs were 6 to 88 dB HL (38±27.3 dB HL), (p=0.002). No significant difference was found between age, gender, number of HBOT sessions and response to treatment (p = 0.581, p = 0.904, p = 0.357, p = 0.184, respectively). Conclusion: Hyperbaric oxygen therapy is a safe and well-tolerated treatment modality for pediatric SSNHL patients. To avoid ethical and legal problems, we think that pediatric patients with a diagnosis of SSNHL should be initiated with the consent of the patient’s parents.

Keywords:

Sudden Hearing Loss, prognosis, child, adolescent, hyperbaric oxygen therapy,

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