突発性難聴に対するステロイド鼓室内注入療法の治療成績 Efficacy of intratympanic steroid treatment on idiopathic sudden sensorineural hearing loss

この論文にアクセスする

この論文をさがす

著者

    • 鈴木 秀明 SUZUKI Hideaki
    • 産業医科大学医学部耳鼻咽喉科 Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
    • 森 貴稔 MORI Takanori
    • 産業医科大学医学部耳鼻咽喉科 Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
    • 大淵 豊明 OHBUCHI Toyoaki
    • 産業医科大学医学部耳鼻咽喉科 Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
    • 寳地 信介 HOHCHI Nobusuke
    • 産業医科大学医学部耳鼻咽喉科 Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
    • 田畑 貴久 TABATA Takahisa
    • 産業医科大学医学部耳鼻咽喉科 Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
    • 池嵜 祥司 IKEZAKI Shoji
    • 産業医科大学医学部耳鼻咽喉科 Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
    • 橋田 光一 HASHIDA Koichi
    • 産業医科大学医学部耳鼻咽喉科 Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health

抄録

突発性難聴に対するステロイド鼓室内注入療法 (IT) の効果を、高気圧酸素療法 (HBO) と比較して検討した。対象は治療開始までが30日以内で初診時聴力が40 dB以上の突発性難聴患者240例で、全例においてステロイド全身投与を行い、これに加えて174例に対しHBOを (HBO群)、66例に対しITを (IT群) 併用した。聴力回復の評価は、厚生省研究班の診断基準に基づいた治癒率、著効率、有効率、および聴力改善率、治療後聴力レベル、聴力利得の計6指標について行った。その結果、症例全体の有効率は、HBO群に比べてIT群で有意に高く (81.8% vs. 68.4%、p=0.039)、多重ロジスティック回帰分析でも同様の結果が確認された。めまい (-) の場合および治療開始までが7日以内の場合の有効率もIT群において有意に高かった。以上より、HBOと比較してITのほうが突発性難聴に対してより有効であることが示された。

We studied the efficacy of intratympanic steroid treatment on idiopathic sudden sensorineural hearing loss (ISSNHL) in comparison with hyperbaric oxygen therapy (HBO). Two hundred and forty consecutive patients with ISSNHL (initial hearing level ≥ 40 dB, time from onset to the start of treatment ≤ 30 days) were enrolled. In addition to systemic steroid administration to all patients, 174 underwent HBO (HBO group) and 66 received the intratympanic dexamethasone injection (IT group). Hearing outcomes were evaluated by 6 indices; the cure rate, marked-recovery rate, and recovery rate according to the criteria of the Ad Hoc Committee of the Japanese Ministry of Health, Labor and Welfare, and the hearing improvement rate, hearing level after treatment, and hearing gain. The overall recovery rate was significantly higher in the IT group than in the HBO group (81.8% vs. 68.4%, p = 0.039), which was confirmed by multiple logistic regression analysis (odds ratio = 2.184; 95% confidence interval, 1.015-4.701; p = 0.046). The recovery rate in the patients without vertigo and that in the patients treated within 7 days from onset were also higher in the IT group than in the HBO group (87.8% vs. 72.4%, p = 0.043; 87.0% vs. 72.7%, p = 0.036). These results indicate that the intratympanic steroid treatment is more effective than HBO on ISSNHL.

収録刊行物

  • Otology Japan

    Otology Japan 21(3), 238-243, 2011-07-25

    日本耳科学会

参考文献:  15件中 1-15件 を表示

各種コード

  • NII論文ID(NAID)
    10030285126
  • NII書誌ID(NCID)
    AN10358085
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    09172025
  • データ提供元
    CJP書誌  J-STAGE 
ページトップへ