Efficacy of the additional effect of hyperbaric oxygen therapy in combination of systemic steroid and prostaglandin E1 for idiopathic sudden sensorineural hearing loss
Efficacy of the additional effect of hyperbaric oxygen therapy in combination of systemic steroid and prostaglandin E1 for idiopathic sudden sensorineural hearing loss
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DOI：
10.1016/j.amjoto.2019.102363
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发表时间：
2020-03-01
影响因子：
2.5
通讯作者：
Ikeda, Katsuhisa
中科院分区：
文献类型：
--
作者：
Hara, Satoshi;Kusunoki, Takeshi;Ikeda, Katsuhisa
目的：对特发性突发性感音神经性听力损失（ISSNHL）患者采用高压氧治疗（HBO）、全身性类固醇、前列腺素E-1或任意两种方式联合治疗的疗效进行了研究。然而，HBO、全身类固醇和前列腺素E-1联合治疗这种疾病的疗效知之甚少。我们的目的是研究HBO联合全身性类固醇和前列腺素E-1作为三联疗法治疗ISSNHL患者的疗效。材料和方法：我们回顾性评估了67例接受全身类固醇和前列腺素E-1治疗（n = 38）或未（n = 29） HBO治疗的ISSNHL患者的记录。纳入标准为症状出现后14天内诊断为ISSNHL，年龄bb0 = 15岁，按方案治疗，临床随访至少1个月。在听力丧失1个月后评估患者的听力水平。主要结果是纯音听力测量的听力改善。我们还评估了患者的人口统计资料。结果：三联治疗组患者的听力改善程度显著高于未进行高压氧治疗组（p < 0.01），但两组间存在一定差异。多因素logistic回归分析显示，校正混杂因素后，纯音听力改善与高压氧治疗之间存在显著正相关（优势比= 7.42;95%，可信区间= 2.37-23.3;p = 0.001）。结论：HBO联合全身类固醇和前列腺素E-1给予ISSNHL显著的治疗效果。因此，建议ISSNHL患者常规使用三联疗法。
Purpose: The efficacies of hyperbaric oxygen therapy (HBO), systemic steroid, prostaglandin E-1 or the combination of any two modalities have been reported in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). However, little is known about the combined efficacy of HBO, systemic steroid, and prostaglandin E-1 for this disorder. We aimed to investigate the efficacy of HBO combined with systemic steroids and prostaglandin E-1 as triple therapy in patients with ISSNHL.Materials and methods: We retrospectively evaluated the records of 67 patients with ISSNHL who were treated with systemic steroid and prostaglandin E-1 with (n = 38) or without (n = 29) HBO. The inclusion criteria included a diagnosis of ISSNHL within 14 days of symptom onset, age >= 15 years, treatment according to the protocol, and clinical follow-up of at least 1 month. The patients' hearing levels were evaluated 1 month after hearing loss onset. The primary outcome was hearing improvement on pure tone audiometry. We also evaluated the demographic profiles of patients.Results: Patients treated with triple therapy showed significantly greater hearing improvement (p < 0.01) than those treated without HBO, despite some differences between the two treatment groups. Multivariate logistic regression analysis revealed a significant positive correlation between pure tone audiometry improvement and hyperbaric oxygen therapy, after adjustment for confounding factors (odds ratio = 7.42; 95% and confidence interval = 2.37-23.3; p = 0.001).Conclusion: HBO with systemic steroid and prostaglandin E-1 administration conferred significant therapeutic benefits for ISSNHL. Therefore, routine use of triple therapy is recommended for patients with ISSNHL.