ORIGINAL RESEARCH
The Effect of Audiogram Configuration on Prognosis in Idiopathic Sudden Hearing Loss
Ä°diyopatik Ani Ä°ÅŸitme Kaybında Odyogram Konfigürasyonununun Prognoza Etkisi
Received Date : 28 Sep 2021
Accepted Date : 19 Jan 2022
Available Online : 27 Jan 2022
Dursun Mehmet MEHELa, Ömer KÜÇÜKÖNERb, Doğukan ÖZDEMİRa, Mehmet CELEBİa, Abdulkadir ÖZGÜRc
aSağlık Bilimleri Üniversitesi Samsun Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları Kliniği, Samsun, TÜRKİYE
bOndokuz Mayıs Üniversitesi Sağlık Bilimleri Fakültesi, Odyoloji Bölümü, Samsun, TÜRKİYE
cYeni Yüzyıl Üniversitesi Gaziosmanpaşa Hastanesi, Kulak Burun Boğaz Hastalıkları Kliniği, İstanbul, TÜRKİYE
Doi: 10.24179/kbbbbc.2021-86394 - Makale Dili: TR
KBB ve BBC Dergisi. 2022;30(2):57-62
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: To evaluate the audiological configuration,
begining time of the treatment, treatment applied, treatment success
and gain distribution according to frequencies of patients with sudden
hearing loss (SHL). Material and Methods: This study included 56
patients with SHL. Age, gender, time between the onset of hearing loss
and admission to the hospital, audiogram types at first admission, degrees
of hearing loss, and frequencies of best-worst response to treatment
were evaluated in patients who had their 6th month follow-up and
audiograms after discharge. Results: The most common configuration
at the first presentation was flat type in 25 (44.6%) patients, and the
least common configuration was total type in 8 (14.3%) patients. While
moderate or complete recovery was observed in 35 (62.5%) of the patients
in the control audiogram results at the 6th month, no improvement
was found in 21 (37.5%). When hearing gains were evaluated, a significant
increase was found at 250, 500, 1,000 and 2,000 Hz. Hearing
gain at high frequencies (4,000 and 8,000 Hz) was not statistically significant.
Conclusion: According to the audiogram configuration, after
steroid treatment in patients with SHL, the best gain was in the ascending
type, and the least gain was in the descending type. In terms of
hearing gain, there was no effect on the prognosis of the treatment initiation
time. Studies examining long-term results may contribute to the
determination of prognostic factors.
Keywords: Sudden hearing loss; steroid therapy; audiogram configuration; prognosis
ÖZET
Amaç: Bu çalışmanın amacı, ani işitme kaybı (AİK) olan hastaların
odyolojik konfigürasyonu, tedaviye başlama süresi, uygulanan
tedavi, tedavi başarısı ve frekanslara göre kazanç dağılımının değerlendirmektir.
Gereç ve Yöntemler: Çalışmaya AİK tanılı 56 hasta
dâhil edildi. Taburcu olduktan sonra 6. ay kontrolleri ve odyogramları
bulunan hastaların, yaş, cinsiyet, işitme kaybının başlangıcı ile hastaneye
başvuru arasında geçen süre, ilk başvurudaki odyogram tipleri,
işitme kaybı dereceleri ve tedaviye en iyi-en kötü yanıt veren frekanslar
değerlendirildi. Bulgular: İlk başvuruda en sık görülen konfigürasyon
25 (%44,6) hastada düz tip, en az görülen konfigürasyon 8 (%14,3)
hastada total tip bulundu. Hastaların 6. aydaki kontrol odyogram sonuçlarında
35’inde (%62,5) orta ya da tam iyileşme gözlenirken,
21’inde (%37,5) iyileşme saptanmadı. İşitme kazançları değerlendirildiğinde
250, 500, 1.000 ve 2.000 Hz’te anlamlı derecede artış tespit
edildi. Yüksek frekanslarda (4.000 ve 8.000 Hz) işitme kazancı olmasına
rağmen istatistiksel olarak anlamlı bulunmadı. Sonuç: AİK’li hastalarda
steroid tedavisi sonrası odyogram konfigürasyonuna göre en iyi
kazanç çıkan tipte, en az kazanç ise inen tipte olmuştur. İşitme kazancı
yönünden, tedaviye başlama süresinin prognoz üzerine etkisi bulunmadı.
Uzun dönem sonuçlarının incelendiği çalışmalar prognostik faktörlerin
belirlenmesine katkı sağlayabilir.
Anahtar Kelimeler: Ani işitme kaybı; steroid tedavisi; odyogram konfigürasyonu; prognoz
KAYNAKLAR
- Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA, et al. Clinical practice guideline: sudden hearing loss (Update). Otolaryngol Head Neck Surg. 2019;161(1_suppl):S1-45. [Crossref] [PubMed]
- Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM, et al. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg. 2012;146(3 Suppl):S1-35. [Crossref] [PubMed]
- Coelho DH, Thacker LR, Hsu DW. Variability in the management of idiopathic sudden sensorineural hearing loss. Otolaryngol Head Neck Surg. 2011;145(5):813-7. [Crossref] [PubMed]
- Saeki N, Kitahara M. Assessment of prognosis in sudden deafness. Acta Otolaryngol Suppl. 1994;510:56-61. [Crossref] [PubMed]
- Booth JB. Sudden and fluctuant sensorineural hearing loss. In: Kerr AG, ed. Scott Brown's Otolaryngology. 6th ed. London: Butterworths-Heinemann; 1997. p.1-82.
- Atay G, Kayahan B, Çınar BÇ, Saraç S, Sennaroğlu L. Prognostic factors in sudden sensorineural hearing loss. Balkan Med J. 2016;33(1):87-93. [Crossref] [PubMed] [PMC]
- Smoak KA, Cidlowski JA. Mechanisms of glucocorticoid receptor signaling during inflammation. Mech Ageing Dev. 2004;125(10-11):697-706. [Crossref] [PubMed]
- Chandrasekhar SS. Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otol Neurotol. 2001;22(1):18-23. [Crossref] [PubMed]
- Gianoli GJ, Li JC. Transtympanic steroids for treatment of sudden hearing loss. Otolaryngol Head Neck Surg. 2001;125(3):142-6. [Crossref] [PubMed]
- Jung AR, Kim MG, Kim SS, Kim SH, Yeo SG. Clinical characteristics and prognosis of low frequency sensorineural hearing loss without vertigo. Acta Otolaryngol.2016;136(2):159-63. [Crossref] [PubMed]
- Dallan I, Fortunato S, Casani AP, Bernardini E, Sellari-Franceschini S, Berrettini S, et al. Long-term follow up of sudden sensorineural hearing loss patients treated with intratympanic steroids: audiological and quality of life evaluation. J Laryngol Otol. 2014;128(8):669-73. [Crossref] [PubMed]
- Rauch SD. Clinical practice. Idiopathic sudden sensorineural hearing loss. N Engl J Med. 2008;359(8):833-40. [Crossref] [PubMed]
- Tüzemen G, Kasapoğlu F, Hızalan İ, Akyıldız MY. The importance of the first three days and other diagnostic indicators in sudden hearing loss. Kulak Burun Bogaz Ihtis Derg. 2016;26(6):333-41. [Crossref] [PubMed]
- Conlin AE, Parnes LS. Treatment of sudden sensorineural hearing loss: II. A Meta-analysis. Arch Otolaryngol Head Neck Surg. 2007;133(6):582-6. [Crossref] [PubMed]
- Park KH, Lee CK, Lee JD, Park MK, Lee BD. Combination therapy with systemic steroids, an antiviral agent, anticoagulants, and stellate ganglion block for treatment of sudden sensorineural hearing loss. Korean J Audiol. 2012;16(2):71-4. [Crossref] [PubMed] [PMC]
- Psillas G, Rizou A, Rachovitsas D, Tsiropoulos G, Constantinidis J. Hearing outcome of low-tone compared to high-tone sudden sensorineural hearing loss. Int Arch Otorhinolaryngol. 2019;23(1):65-9. [Crossref] [PubMed] [PMC]
- Nakashima T, Kuno K, Yanagita N. Evaluation of prostaglandin E1 therapy for sudden deafness. Laryngoscope. 1989;99(5):542-6. [Crossref] [PubMed]
- Kuhn M, Heman-Ackah SE, Shaikh JA, Roehm PC. Sudden sensorineural hearing loss: a review of diagnosis, treatment, and prognosis. Trends Amplif. 2011;15(3):91-105. [Crossref] [PubMed] [PMC]