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Optimal First-Line Therapy for Acute Low-Tone Sensorineural Hearing Loss

  • Shin, Seung-Ho (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University) ;
  • Byun, Sung Wan (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University) ;
  • Park, Sohl (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University) ;
  • Kim, Eun Hye (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University) ;
  • Kim, Min Woo (Department of Otorhinolaryngology, Daejeon Eulji University Medical Center, Eulji University School of Medicine) ;
  • Lee, Ho Yun (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University)
  • 투고 : 2021.04.14
  • 심사 : 2021.05.16
  • 발행 : 2021.10.20

초록

Background and Objectives: We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results. Subjects and Methods: We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital's otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated. Results: Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results. Conclusions: A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.

키워드

과제정보

This research was supported by by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2017R1C1B5017839 for HYL).

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