Idiopathic sudden sensorineural hearing loss - Results after 3 years of therapeutic protocol implementation
DOI:
https://doi.org/10.34631/sporl.197Keywords:
hearing loss, sensorineural, sudden, idiopathic, corticosteroids, pentoxifilin, hyperbaric oxygen, valacyclovirAbstract
Introduction: The idiopathic sudden sensorineural hearing loss (ISSHL) is a clinical diagnosis, characterized by a sensorineural hearing loss of at least 30 decibel (dB) over three contiguous frequencies occurring within 72 hours. This study pretends to evaluate the results of the therapeutic protocol instituted in the ENT Department of Hospital de São Sebastião, in what concerns to hearing recovery (pure tone average in dB).
Methods and Material: Retrospective study, by clinical files analysis, of all patients with the diagnosis of ISSHL between January 2008 and December 2010 (three years), that were treated with the therapeutic protocol of Hospital de São Sebastião (Centro Hospitalar Entre o Douro e Vouga) ENT Department. Patients that were treated with outpatient treatment were excluded, which include those who presented with a clinical evolution of more than fifteen days and those that refused to be admitted for treatment. Patients were admitted in our Department to perform intravenous therapy with prednisolone, pentoxifilin and valacyclovir. Subsequent hyperbaric oxygen therapy was proposed to all patients that didn’t have a significant hearing improvement, and started, preferably, during the first week after hospital discharge.
Results: Information was collected from 11 patients, 6 male and 5 female patients, with a mean age of 51,1 years (39- 63 years). At time of diagnosis, all patients presented with homolateral tinnitus and five patients (45,5%) with vertigo complaints. The initial pure tone average (PTA), calculated as the average of thresholds at 500, 1000, 2000 and 4000 Hz, was 82 dB. Hyperbaric oxygen therapy was performed in seven patients. The rest of the patients refused this treatment. After treatment the average PTA was 50 dB (15-107,5 dB), with an average improvement of 32,6 dB (0-85 dB). There were two patients without audiometric recovery. In the group of patients that performed hyperbaric oxygen therapy, there was a significant audiometric recovery (equal or superior to 20 dB) in four patients (57%).
Conclusion: Despite the auditory improvements, the results are still insufficient, and the best treatment is still to be found. Despite the small sample and lack of statistical significance of our results, it seems to the authors that the hyperbaric oxygen therapy should be offered as a therapeutic option.
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