Local hypothermia in the treatment of idiopathic sudden sensorineural hearing loss
Local hypothermia in the treatment of idiopathic sudden sensorineural hearing loss
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DOI：
10.1016/j.anl.2010.01.008
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发表时间：
2010-10-01
影响因子：
1.7
通讯作者：
Gyo, Kiyofumi
中科院分区：
文献类型：
--
作者：
Hato, Naohito;Hyodo, Jun;Gyo, Kiyofumi
目的：局部低温和限制活动在治疗特发性突发性感音神经性听力损失（ISSHL）的加成作用进行了调查的病例匹配研究作为一个多中心（13家医院）pilot trial.Patients和方法：在一个初步的实验中，我们评估了冷水枕（15摄氏度）的影响。用枕头冷却颈部和乳突，2 h内鼓膜温度下降1.4 ℃，无不适感和冻伤。在这项研究中，86例ISSHL患者被纳入低温组，除药物治疗外，还接受了限制活动的低温治疗，86例ISSHL患者构成对照组，接受相同的药物治疗，但没有冷却和休息。对照组患者从病例记录中回顾性选择，通过匹配实验患者的年龄，性别，治疗开始前的天数，听力损失，听力图形状和伴随的眩晕。低温组在常规药物治疗基础上，采用冷水枕治疗48 h，泼尼松60 mg）7天。将水枕冷却至15摄氏度，每天更换4-5次。患者入院后前48 h使用水枕，活动受限。对照组患者只接受药物治疗。结果：听力结果进行了评价，使用标准提出的突发性感音神经性听力损失研究小组，日本卫生和福利部。在发病后6个月判断恢复率。亚低温组治愈率明显优于对照组（P < 0.05）。当比较仅限于年轻的患者，使用冷水枕是有效的，在促进恢复hearing.Conclusions：听力恢复ISSHL可能会提高通过添加亚低温和限制活动的常规治疗。(C)2010爱思唯尔爱尔兰有限公司版权所有。
Objective: The additive effects of local hypothermia and restricted activity in the treatment of idiopathic sudden sensorineural hearing loss (ISSHL) were investigated by case-matched study as a multicenter (13 hospitals) pilot trial.Patients and methods: In a preliminary experiment, we evaluated the effects of cooled water pillow (15 degrees C). Cooling the neck and mastoid with the pillow decreased the tympanic membrane temperature for 1.4 degrees C in 2 h without causing uncomfortable sensation or frostbite. In this study, 86 patients with ISSHL were enrolled in the hypothermic group, which received hypothermic treatment with restricted activity in addition to medication, and 86 ISSHL patients constituted the control group, which received the same medication but without cooling and rest. Control patients were selected retrospectively from case records by matching the experimental patients with respect to age, gender, days until the start of treatment, hearing loss, shape of the audiogram, and accompanying vertigo. The patients in the hypothermic group were admitted and treated with a cooled water pillow for 48 h, in addition to conventional drug treatment (e.g., 60 mg of prednisone) for 7 days. The water pillow was cooled to 15 degrees C and was changed 4-5 times per day. The patients used the water pillow for the first 48 h after admission, with restricted activity. The control patients received only the medications.Results: Hearing results were evaluated using criteria proposed by the Sudden Sensorineural Hearing Loss Research Group of the Japanese Ministry of Health and Welfare. The recovery rates were judged 6 months after onset. The recovery rate in the hypothermic group was significantly (p < 0.05) better than that in the control group. When the comparison was limited to younger patients, the use of the cooled water pillow was effective in facilitating the recovery of hearing.Conclusions: Hearing restoration in ISSHL may be improved by adding mild hypothermia and restricted activity to the conventional treatment. (C) 2010 Elsevier Ireland Ltd. All rights reserved.