Comparison of Oral Steroid and Intravenous Steroid plus Dextran Treatments on the Prognosis of Sudden Sensorineural Hearing Loss

口服類固醇及靜脈注射類固醇加上葡聚糖對於突發性耳聾治療預後之比較

林忠青(Chung-Ching Lin) ； 黃俊豪(Juen-Haur Hwang)

《台灣耳鼻喉頭頸外科雜誌》 50卷1期 (2015/03) Pp. 19-26

https://doi.org/10.6286/2015.50.1.19

摘要

背景：突發性耳聾的定義是在72小時之內出現連續3個頻率大於30 dB的感音神經性聽力損失。治療的準則鄉住院病患及門診病患會有所不同。儺管如此，靜脈注射類固醇加上葡聚糖跟口服類固醇在治療放果上的差別依然未明。因此本篇的目的在於比較靜脈注射類固醇加上葡聚糖跟口服類固醇對突發性耳聾的治療預後有無差異性。方法:本研究包含了254診斷為突發性耳聾的成年人。所有的病患依治療方式分為兩組：靜脈注射類固醇及口服類固醇。靜脈注射類固醇及口服類固醇在治療後聽力恢後的勝算比使用多元邏輯迴歸分析來評估。結果：在口服類固醇組為119（46.9%）名，而在靜脈注射類固醇組為135（53.1%）名。口服類固醇組比靜脈注射類固醇組的病患年齡較大，發病後到接受治療的間隔較長，聽力損失較小，較多比例有暈眩及頭痛。經多元邏輯迴師分析後兩組治療的預後無顯著的差異性存在。年齡和高血壓跟突發性耳聾的預後程明顯的負相關性，特別是年齡小於65歲的族群。結果：突發性耳聾的預後在靜脈注射類固醇及口服類固醇兩組之間並無顯著差異性存在。

關鍵字

突發性感覺神經性聽力喪失 ； 預後 ； 靜脈注射類固醇 ； 葡聚糖 ； 口服類固醇

並列摘要

Background: Sudden sensorineural hearing loss (SSHL) is defined as a loss of greater than 30 dB in three contiguous frequencies in less than 3 days. The treatment protocols for SSHL are different for inpatients and outpatients. Even so, the effects of the effects of intravenous steroid plus dextran (IVSD) and oral steroid (OS) treatments on the recovery of SSHL remain unclear. The purpose of this study was to investigate the effects of intravenous steroid plus dextran (IVSD) and oral steroid (OS) treatments on the prognosis of sudden sensorineural hearing loss (SSHL). Methods: We collected 254 adult patients with SSHL. All patients were divided into two groups based on the treatment protocols: IVSD group and OS group. The odds ratio of IVSD group versus OS group on the recovery of SSHL was evaluated using a multivariate logistic regression analysis. Results: There were 119 (46.9%) patients in the OS group and 135 (53.1%) patients in the IVSD group. The OS group had older patients, longer time elapsed from onset of SSHL to initial treatment, milder initial and treated hearing loss severities, and higher prevalences of vertigo and headache than the IVSD group. However, the outcome of SSHL treatment was not significantly in either group. Multivariate logistic regression analysis showed that the treatment protocol was not significantly associated with the recovery of SSHL for all patients, after adjusting for all considered variables. Age and hypertension showed significantly inverse associations with the recovery of SSHL, especially for patients younger than 65 years. Conclusions: The prognosis of SSHL was not significantly different between the IVSD and OS groups.

並列關鍵字

sudden sensorineural hearing loss ； prognosis ； intravenous steroid ； dextran ； oral steroid