Dr. Ameen, ENT Specialist in Kuala Lumpur

Today, i am going to share with you, the options available at our centre in regards to treatment of sudden sensorineural hearing loss, and which one is superior? 🙂 Kindly go through this nicely done research.

Abstract

Objectives: 

Systemic steroids are the most common first-line therapy in sudden sensorineural hearing loss (SSNHL), with significant improvement in hearing outcomes in over 60% of patients. It is unknown why 40% of patients do not respond to systemic steroid therapy. Salvage treatment includes intratympanic steroids (ITS) and hyperbaric oxygenation (HBO) therapy, with inconsistent results reported. This study aimed to compare the results of ITS and HBO therapy in patients with SSNHL that previously failed systemic steroid therapy.

Design: 

This is a comparative retrospective nonrandomized interventional cohort study, enrolling 126 patients with SSNHL. Out of these, 35 patients received HBO therapy, 43 patients received ITS, and 48 patients did not receive any second-line therapy (control group). Pure-tone audiograms were performed before and after the salvage therapy in the IT and HBO groups and at the same time interval in the control group. Study variables included age, time until therapy initiation, tinnitus status, and hearing outcomes, with a cutoff criteria of cumulative >30 dB improvement on all frequencies indicating recovery.

Results: 

ITS and HBO therapy were associated with statistically significant hearing recovery at all frequencies compared to systemic steroids. The results show an average hearing improvement of 13.6 dB overall frequencies (250 to 8000 Hz) after ITS therapy and 7.4 dB in HBO therapy in comparison to the control group. Presence of significant hearing improvement positively correlated with age, ITS therapy, and HBO therapy. Presence of tinnitus before therapy was negatively correlated with hearing improvement. Patients with tinnitus present at the start of therapy improve 4.67 dB less on average compared to those without tinnitus. ITS therapy significantly reduced tinnitus compared to the other two treatment options. Patients with tinnitus present before therapy significantly improve hearing at low frequencies, compared to the control group.

Conclusions: 

ITS and HBO therapy show superior hearing results compared to observation alone after failed oral steroid therapy for SSNHL. ITS shows an additional positive impact on tinnitus reduction and shows superior hearing outcomes after salvage therapy.

KOMEN SAYA:

Kita sure akan gelabah dan risau jika secara tiba-tiba, deria pendengaran kita hilang (Sudden sensorineural Hearing Loss – SSNHL). Jika ia berlaku, jangan buang masa di rumah ya. Segera pergi ke hospital yang terdapat service ENT untuk mendapat rawatan segera. Lebih cepat rawatan diterima, lebih tinggi peratusan untuk deria pendengaran kembali pulih!!

Biasanya, pesakit akan diberi ubat makan steroid (systemic steroid) jika tiada contraindication untuk steroid systemic seperti diabetes/immunocompromised state. Jika ada, peserta boleh diberi intratympanic steroid injection (ITS) iaitu rawatan di mana steroid akan disuntik terus tembus melalui gegendang telinga ke dalam ruang telinga tenga. Pesakit juga boleh melalui beberapa siri hyperbaric oxygen therapy (HBO), kini servisnya ada di Hospital Angkatan Tentera Tuanku Mizan.

Mengikut artikel di atas, ITS dan HBO memberi impak positif dari segi peratusan pulih pendengaran jika dibandingkan dengan ubat makan steroid! Maka ITS dan HBO adalah satu pilihan yang lagi baik 🙂

Sila tonton video di bawah untuk mengetahui lebih lanjut tentang SSNHL ya 🙂