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ORIGINAL RESEARCH

The Effect of Combined Use of Intratympanic Steroid Therapy on Sudden Hearing Loss
Ani İşitme Kaybında İntratimpanik Steroid Tedavisinin Kombine Kullanılmasının İşitme Kazancı Üzerine Etkisi
Received Date : 17 Feb 2019
Accepted Date : 29 May 2019
Doi: 10.24179/kbbbbc.2019-65586 - Makale Dili: TR
KBB ve BBC Dergisi 2019;27(2):51-6
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The aim of this study was to determine the effects of high-dose systemic steroid therapy and consecutive intratympanic steroid injections at the beginning of treatment with lower dose systemic steroid therapy (combined treatment) on the clinical and audiological recovery in the treatment of sudden hearing loss. Material and Methods: The study was done by retrospective analysis of the records of 52 patients who were diagnosed with sudden hearing loss between 2002- 2005. Twenty-four of the patients were in the high dose systemic steroid treatment group and 28 were in the intratympanic steroid treatment with lower dose systemic steroid therapy group (combined treatment). Pure tone averages of 500-1000-2000-4000 Hertz (Hz) frequencies were examined in the patients before and after treatment. The pure tone averages was determined on these four thresholds, and differences of 10 dB and above were considered as gain. In the evaluation of the findings; chi-square test and student-t test were used, p<0.05 was considered statistically significant. Results: The rate of recovery in pure voice after treatment was 16,7% in the high dose systemic steroid treatment group and 50% in the combined treatment group. The combined treatment group had better hearing recovery than in the high dose systemic steroid treatment group. There was no significant difference in the mean sound gain between the two groups on the 7th, 15th and 30th days. Conclusion: This study shows that the addition of intratympanic steroid treatment to systemic steroid therapy increases hearing gain and can reduce the dose of systemic steroids in sudden hearing loss.
ÖZET
Amaç: Ani işitme kaybı tedavisinde, yüksek doz sistemik steroid tedavisinin ve günaşırı ardışık intratimpanik steroid enjeksiyonunun, başlangıçta daha düşük dozda sistemik steroid tedavisi (kombine tedavi) ile birlikte verilmesinin klinik ve odyolojik düzelmeye olan etkilerini ortaya çıkarmaktır. Gereç ve Yöntemler: Bu çalışma; 2002-2005 yılları arasında ani işitme kaybı tanısı konularak tedavi edilen 52 hastanın dosya kayıtlarının retrospektif olarak incelenmesi ile yapıldı. Hastaların 24’ü yüksek doz sistemik steroid tedavisi grubunda, 28’i intratimpanik steroid enjeksiyonu ve düşük dozda sistemik steroid tedavisi grubunda idi (kombine tedavi). Hastaların, tedavi öncesi ve sonrası odyolojik tetkiklerinde, 500-1000-2000-4000 Hertz (Hz) frekanslarında saf ses ortalamalarına bakıldı. Saf ses ortalaması bu dört eşikte saptanarak 10 dB ve üzerindeki farklar kazanç olarak kabul edildi. Bulguların değerlendirilmesinde ki-kare testi ve student-t testi kullanıldı, p<0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Tedaviden sonra saf ses ortalamasındaki iyileşme oranı yüksek doz sistemik steroid tedavi grubunda %16,7, kombine tedavi grubunda %50 idi. Kombine tedavi grubunda iyileşmedeki düzelme yüksek doz sistemik steroid tedavi grubuna göre daha iyi bulundu. Her iki tedavi grubunda, yedi, 15 ve 30. günlerde saptanan saf ses ortalama kazançları karşılaştırıldığında anlamlı fark bulunmadı. Sonuç: Bu çalışma, sistemik steroid tedavi intratimpanik steroid tedavisinin eklenmesinin, ani işitme kaybında işitme kazancını artırdığını ve sistemik steroid dozunun azaltılabildiğini göstermektedir.
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