저음역 돌발성 난청 환자에서 고실 내 덱사메타존 주입술 및 경구 스테로이드 병합 요법의 효과와 경구 스테로이드 복용량 조절을 위한 예비연구

Backgrounds and Objectives: Prevalence of low tone sudden sensorineural hearing loss (LSSNHL) has increased. However there was no definite treatment regimen of LSSLHL. The objective of this study is to analyze results of oral steroid therapy and intratympanic steroid injection (ITSI) as first line therapy for LSSLHL. Ad- dtionally, we compared side effects as treatment modality. Materials and Methods: We studied retrospectively 43 patients with LSSLHL at Jeju National University Hospital from March 2010 to July 2011. Under approval of patients we classified patients into 3 groups as treatment types. Patients to be treated with only ITSI were classified as group I (n=11), patients to be treated with ITSI and high dose oral methylprednisolone (1 mg/kg/day) were classified as group II (n=9) and patients to be treated with ITSI and half dose oral methylprednisolone (0.5 mg/kg/day) were classified as group III (n=23). Patients got 3 times of ITSI for a week. Before injection we warmed up dexamethasone (5 mg/mL) ample and we injected at posterosuperior portion of tympanic membrane. We carried out a pure tone audiometry (PTA) on the 1st day of their visit to hospital and before injection. We compared change of bone conduction threshold at 250, 500 and 1,000 Hz between 3 groups. Results: The hearing threshold of patients improved regardless of groups since the treatment. And there was no clinically significant differences in the outcome between groups. Conclusions: We could use ITSI as therapy in LSSLHL. If we used oral steroids for treatment of LSSLHL, we could consider reduction dosage of them. (J Clinical Otolaryngol 2012; 23:212–217)