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A comparison of effects of systemic and intratympanic steroid therapies for sudden sensorineural hearing loss:A meta-analysis

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Journal of Otology 2016年第1期11卷 18-23页

作者： Dan Zhao Busheng Tong Qiang Wang Sten Hellstrom Maoli Duan Department of Otorhinolaryngology-Head and Neck Surgery The First Affiliated Hospital of Anhui Medical University Department of Audiology and Neurotology Department of Clinical Science Intervention and Technology Karolinska Institute

Objective:To evaluate the efficacy and safety of intratympanic and systemic steroid therapies in the initial treatment of Sudden Sensorineural Hearing Loss (SSNHL) patients. Methods:A comprehensive search of PubMed, Wanfang database and CNKI (China National Knowledge Infrastructure) was performed covering the period from January 1990 to July 2014. A meta-analysis was conducted after filtering by the criteria of Cochrane Collaboration. Three hundred fifty six subjects in nine studies allocated to the group of intratympanic steroid therapies and 343 controls receiving systemic steroid therapies met the criteria for meta-analysis. The data were extracted and analyzed using the RevMan 5.3 meta-analysis software. Results: The total effectiveness rate in SSNHL patients receiving intratympanic steroid therapies did not differ statistically from patients receiving systemic therapies (RR ? 1.08, 95%CI ? 0.99e1.99, P ? 0.10), although the rate of full hearing recovery in this group differed significantly from patients receiving systemic therapies (RR ? 1.29, 95%CI ? 1.00e1.66, P ? 0.05). Conclusion: Local steroid therapy appears to generate higher rate of complete hearing recovery than systemic steroid treatment as an initial treatment for SSNHL, which may be especially useful for patients in whom systemic steroids are contraindicated.

关键词： Sudden sensorineural hearing loss Intratympanic steroids Systemic steroid Meta-analysis

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Clinical Study on 136 Children with Sudden Sensorineural Hearing Loss

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Chinese Medical Journal 2016年第8期129卷 946-952页

作者： Feng-Jiao Li Da-Yong Wang Hong-Yang Wang Li Wang Feng-Bo Yang Lan Lan Jing Guan Zi-Fang Yin UII Rosenhall Lan Yu Sten Hellstrom Xi-Jun Xu Mao-Li Duan Qiu-Ju Wang Department of Otolaryngology-Head and Neck Surgery Institute of Otolaryngology Chinese PLA General Hospital Beijing 100853 China Department of Otolaryngology-Head and Neck Surgery Kunming General Hospital Kunming Medical University Kunming Yunnan 650032 China Department of Audiology and Neurotology Karolinska University Hospital 17176 Stockholm Sweden Department of Clinical Science Intervention and Technology Karolinska Institute 171 76 Stockholm Sweden

Background：The prevalence of sudden sensorineural hearing loss in children （CSSNHL） is consistently increasing.However,the pathology and prognosis of CSSNHL are still poorly understood.This retrospective study evaluated clinical characteristics and possible associated factors of CSSNHL.Methods：One hundred and thirty-six CSSNHL patients treated in Department of Otolaryngology-Head and Neck Surgery and Institute of Otolaryngology at Chinese PLA General Hospital between July 2008 and August 2015 were included in this study.These patients were analyzed for clinical characteristics,audiological characteristics,laboratory examinations,and prognostic factors.Results：Among the 136 patients （151 ears）,121 patients （121 ears,80.1%） were diagnosed with unilaterally CSSNHL,and 15 patients （30 ears,19.9%） with bilateral CSSNHL.The complete recovery rate of CSSNHL was 9.3%,and the overall recovery rate was 37.7%.We found that initial degree of hearing loss,onset of treatment,tinnitus,the ascending type audiogram,gender,side of hearing loss,the recorded auditory brainstem response （ABR）,and distortion product otoacoustic emissions （DPOAEs） had prognostic significance.Age,ear fullness,and vertigo had no significant correlation with recovery.Furthermore,the relevant blood tests showed 30.8% of the children had abnormal white blood cell （WBC） counts,22.1% had elevated homocysteine levels,65.8% had high alkaline phosphatase （ALP）,33.8% had high IgE antibody levels,and 86.1% had positive cytomegalovirus （CMV） IgG antibodies.Conclusions：CSSNHL commonly occurs unilaterally and results in severe hearing loss.Initial severe hearing loss and bilateral hearing loss are negative prognostic factors for hearing recovery,while positive prognostic factors include tinnitus,gender,the ascending type audiogram,early treatment,identifiable ABR waves,and DPOAEs.Age,vertigo,and ear fullness are not correlated with the recovery.Some serologic indicators,including the level of WBC,platelet,homocysteine,ALP,positive CMV IgG antibody,fibrinogen,and some

关键词： Audiological Characteristics Children Laboratory Examinations Prognostic Factors Sudden Hearing Loss

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