Nagihan BİLAL, Mehmet Ali KARSAVUL, İsrafil ORHAN, Saime SAĞIROĞLU, Muhammed Gazi YILDIZ, İrfan KARA, Adem DOĞANER, Emine TEMİZ

Ani idiyopatik İşitme Kayıplarında Kombine Steroid Tedavisinin Etkinliği Prognostik Faktörlerle İlişkisi

Amaç:Çalışmamızda Ani idiopatik sensorinöral işitme kaybı (AİK) olanlarda belirlediğimiz prognostik faktörlerin ve kombine tedavilerin, intratimpanik steroid enjeksiyonu sonrası işitmedeki düzelme üzerine etkilerini araştırdık. Gereç ve yöntemler:2018-2019 yılları arasında Kahramanmaraş Sütçü İmam Üniversitesi Kulak Burun Boğaz kliniğinde AİK sebebiyle ayaktan veya yatarak tedavi alan, başka sağlık kuruluşunda tedavi almamış ve işitme kaybının başlangıcı ile tedaviye başlama arasında geçen süre 3 haftadan kısa olan 30 hasta retrospektif olarak incelendi. Bulgular:Çalışmaya 17 kadın 13 erkek olmak üzere 30 hasta dahil edildi. Hastaların yaş ortalaması 46 idi.Hastaların iyileşme düzeyleri Siegel kriterlerine göre değerlendirildi ve %30’unda (n=9) tip 1 (tam düzelme), %10’unda (n=3) tip 2 (belirgin düzelme), %10’unda (n=3) tip 3 (hafif düzelme) ve %50’sinde (n=15) tip 4 (düzelme yok) olarak kaydedildi. Çalışmamıza dahil edilen komorbid faktörler arasında, diğer faktörlerin iyileşme üzerine anlamlı etkisi yoktu (p>0,05). Buna ek olarak intratimpanik steroid enjeksiyonu ile kombine olarak verilen tedaviler arasında da işitme kazanımları açısından istatistiksel olarak anlamlı bir fark bulunmadı. Hasta grubumuzdaki öykü süreleri bir gün ile yirmibir gün arasında değişmekteydi ve çalışmamızda şikayet ile tedaviye başlama arasında geçen süre beş günden kısa olanlarda iyileşme anlamlı bulundu (p<0,05). Sonuç: Ani işitme kaybı; acil tanı konulup acil tedavi edilmesi gereken bir durumdur. Tedavi edilmediğinde kalıcı işitme kayıplarına, bireyin psikolojik, bilişsel, sosyal gelişimi üzerine olumsuz etkilere sebep olabilir. Çalışmamızda yalnızca intratimpaniksteroid tedavisi ve kombine tedavilerin birbirine üstünlük göstermediği bulundu.

Anahtar Kelimeler:

işitme kaybı, intratimpanik steroid, sistemik steroid

The Effectiveness of Combined Steroid Therapy in Sudden Idiopathic Hearing Loss and Its Relationship with Prognostic Factors

Introduction: In our study, we investigated the effects of prognostic factors and combined therapies that we determined in patients with sudden hearing loss on hearing improvement after intratympanic steroid injection. Material Method: Between 2018 and 2019, 30 patients were examined retrospectively who received outpatient or inpatient treatment for Idiopathic sudden sensorineural hearing loss (ISSNHL) in KahramanmarasSutcu Imam University Ear Nose and Throat clinic and did not receive treatment in another healthcare institution and the period between the onset of hearing loss and starting treatment was less than 3 weeks. Results: 30 patients, 17 female and 13 male, were included in our study. The average age of the patients was 46. Recovery levels of patients were evaluated according to Siegel criteria and type 1 (complete improvement) in 30% (n = 9), type 2 (significant improvement) in 10% (n = 3), type 3 (mild improvement) in 10% (n = 3) and 50% (n = 15) were recorded as type 4 (no improvement). Among the comorbid factors included in our study, while other factors had no significant effect on recovery (p> 0.05). In addition, there was no statistically significant difference in terms of hearing gains between treatments given in combination with intratympanic steroid injection. The duration of the history of outpatient group ranged from one day to twenty-one days, and in our study, improvement was found to be significant in those with less than five days between complaints and starting treatment (p <0.05). Conclusion: Sudden hearing loss is a disease that requires immediate diagnosis and treatment. If left untreated, this can lead to permanent hearing loss and negative effects on the patient's psychological, cognitive, and social development. In our study, it was understood that only intratympanic steroid treatment and combined therapies did not show superiority to each other.

Keywords:

sudden hearing loss, intratympanic steroid, systemic steroid,

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