KMID : 0361020200630100497
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Korean Journal of Otolaryngology - Head and Neck Surgery 2020 Volume.63 No. 10 p.497 ~ p.504
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Comparison among Three Different Steroid Therapies for Idiopathic Sudden Sensorineural Hearing Loss
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Jung Da-Jung
Lee Ji-Hoon Yoo Myung-Hoon Lee Kyu-Yup
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Abstract
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Background and Objectives: The optimal dose or type of systemic steroid for treating idiopathicsudden sensorineural hearing loss (ISSNHL) is unclear. Herein, we compare the efficacyof three steroid treatment protocols.
Subjects and Method: We reviewed the medical records of 140 adult ISSNHL patients froma tertiary medical center. The patients were divided into three groups based on their treatmentregimen: Group 1 received intravenous 10 mg/day dexamethasone combined with intratympanic(IT) steroid injection, followed by prednisolone for 5 days after discharge; Group 2 received 10mg/day dexamethasone for 5 days, followed by 5 mg/day for 5 days over a 10-day hospitalizationperiod; and Group 3 received 10 mg/day dexamethasone combined with IT steroid injectionduring a 5-day hospital stay, followed by 5 mg/day dexamethasone for 5 days after discharge.
The hearing thresholds were measured using an automatic audiometer at 0.5, 1, 2, 3, 4, and 8kHz. Hearing recovery on Day 90 was categorized according to Siegel¡¯s criteria.
Results: Univariate and multivariate analyses showed that patients in Group 3 had the lowesthearing thresholds, and the best results for speech reception threshold and speech discriminationscores. The impact of favorable thresholds in Group 3 was better among patients with abaseline average hearing threshold of £¼70 dB. Complete recovery was more likely in Group 3than in the other groups, based on the odds ratios.
Conclusion: Administration of dexamethasone-based systemic steroid combined with IT steroidinjection and a relatively long hospitalization period produced the most favorable result.
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KEYWORD
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Dexamethasone, Intratympanic injection, Sudden sensorineural hearing loss
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