돌발성 난청 환자에서 고실내 스테로이드 주입술 시기에 따른 청력 개선 효과

Abstract

BACKGROUND AND OBJECTIVES: Oral systemic steroids are the most commonly accepted treatment for idiopathic sudden sensorineural hearing loss (SSNHL) despite pathophysiological uncertainty. Recently, intratympanic dexamethasone (ITD) has been proposed as an effective, alternative method for patients in whom oral steroids either fail to respond or are contraindicated. The authors compared the efficacy of ITD according to the duration of hearing loss prior to first dose of ITD. SUBJECTS AND METHOD: We retrospectively reviewed the medical records and audiologic data of 86 SSNHL patients who received ITD from May 2009 to April 2012. Injections were repeated 5 times for 2 weeks and the favorable recovery was defined as complete or partial recovery using Siegel's criteria. We compared the hearing outcomes between pre-ITD and post-ITD with respect to the duration of hearing loss. RESULTS: The mean pure-tone audiograms before and after ITD were 57.91+/-25.52 dB and 50.81+/-24.28 dB (p<0.01), respectively. According to Siegel's criteria, the overall rate of hearing improvement after ITD was 22.1% (19/86). Favorable hearing recovery was observed in 8 of 18 (44.4%) patients within 10 days, 7 out of 41 (17.1%) between 10 days and 20 days, 2 of 18 (11.1%) between 20 days and 30 days, 2 of 7 (28.6%) over 30 days. CONCLUSION: ITD is a useful method as primary or salvage treatment of SSNHL. The results of this study suggest that early ITD after hearing loss increase the probability of hearing recovery.