Curiel DCB, Garduño AMA, González HCB

Language: Spanish
References: 18
Page: 196-204
PDF size: 171.70 Kb.

ABSTRACT

Background: The immediate recognition of sudden hearing loss is even more relevant when we know that any hearing recovery will depend on the speed of treatment delivery.
Objective: To determine the auditory gain in decibels (dB) and the improvement of phonemic discrimination in percentage with the use of combined treatment of dexamethasone infusion of the inner ear and oral prednisone in comparison to the use of each substance separately in the treatment of patients with idiopathic unilateral sensorineural sudden hearing loss.
Patients and methods: Upon approval of the ethics committee and regional teaching hospital, a prospective, randomized, placebo-controlled and single-blind study was conducted with a two years follow-up. Study groups: patients with definite diagnosis of unilateral sensorineural idiopathic sudden hearing loss were randomized into three groups: group 1 receiving infusion combined with dexamethasone and oral prednisone; group 2 treated only with dexamethasone infusion and group 3 treated only with oral prednisone (internal control).
Results: Thirty-five patients were assigned into a treatment group, 12 to group 1 (dexamethasone and oral prednisone), 12 to group 2 (dexamethasone) and 11 to group 3 (prednisone). With regard to records of pure-tone average pretreatment and postreatment, both groups had a similar behavior with 88.7 dB (group 1), 86.5 dB (group 2) and 86.2 dB (group 3) pretreatment and 53.6 dB (group 1), 54.6 dB (group 2) and 56.9 dB (group 3) after treatment with no statistically significant difference. As for improvement in contralateral relative pure tone average and improvement in absolute pure tone average comparing with the contralateral ear hearing, assuming that the hearing level of unaffected ear was the hearing level before the event, we found a behavior quite similar in the three groups: 46.8 ± 42.3 dB (group 1), 49.6 ± 34.7 dB (group 2) and 49 ± 35.5 dB (group 3); and in terms of hearing results after treatment and in absolute terms: 34.9 ± 32.1 dB (group 1), 33.1 ± 20.7 dB (group 2) and 28.9 ± 17.2 dB (group 3), without a statistically significant difference. On the criterion of hearing recovery in group 1, a 33.3% (n = 4) of the patients had no hearing recovery, as well as 25% (n = 3) for group 2 and 27.3% (n = 3) for group 3, a similar behavior among groups and no statistically significant difference. In the three groups there were no complications.
Conclusion: Intratympanic dexamethasone infusion in combination with oral prednisone or alone shows a better therapeutic profile as primary treatment.

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