高壓氧合併耳內注射類固醇治療突發性耳聾的成效

The Effect of Concurrent Hyperbaric Oxygen Therapy with Intratympanic Steroid Injection in Idiopathic Sudden Sensorineural Hearing Loss

突發性耳聾（idiopathic sudden sensorineural hearing loss）指的是3天之內嗹續3個聲音頻率，大於30分貝感音神經性聽力喪失突發性耳聾的治療主要有3大類型：口服或靜脈注射類固醇，耳內注射類固醇與高壓氧治療。本病例報告為2017年一至五月連續八位突發性耳聾的患者，在本院接受耳內注射類固醇合併高壓氧治療，顯示四位在發病兩週內就接受合併治療的病人聽力可恢復81-100%；另四位超過兩週以上再接受合併治療病人聽力的改善只有0-60%，三位有聽力改善皆在低音頻。中有一例右耳年前失聰患者，再發生左耳突發性耳聾，病發後五天後經左耳耳內注射類固醇合併10次高壓氧治療後左耳聽力恢復正常，右耳聽力也有44%的改善。本案例報告顯示耳內注射類固醇合併高壓氧治療對突發耳聾值得進一步的研究。

Abstract: The criteria of Idiopathic sudden sensorineural hearing loss (ISSNHL) is a decrease of hearing larger than 30 decibels (dB), affecting at least 3 consecutive frequencies, occurring within a 72-hour period. The current treatment options include oral or systemic steroid, intratympanic steroid injection (ITS), and hyperbaric oxygen therapy (HBOT). We reported 8 consecutive cases of ISSNHL treated with concurrent HBOT and ITS from January to May 2017. Four cases treated within 2 weeks after the onset of ISSNHL had 81-100% gain of hearing in all frequencies of audiogram. The other four cases treated 2 weeks after the onset of ISSNHL had 0-60% gain in low frequencies of audiogram in three cases. A case with right hearing loss 5 years ago received concurrent left ITS and HBOT 5 days after the onset of left ISSNHL. After 10 sessions of HBOT there were complete recovery of hearing of left ear and 44% gain in low frequencies of audiogram of right ear. The findings of the present study encourage further research on the treatment of ISNHL with concurrent use of HBOT and ITS.