당뇨환자에서 발생한 돌발성 난청에 대한 스테로이드 전신 투여와 고실내 주입의 치료효과 비교

한치성; 박종률; 김현범; 안중기; 박정홍; 강명구; 이원용; 김종애

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자료유형: 학술저널

저자정보: 한치성 박종률 김현범 안중기 박정홍 강명구 이원용 김종애

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제51권 제3호

발행연도: 2008.1

수록면: 227 - 233 (7page)

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High dose systemic steroid therapy is currently the mainstay of the treatment for sudden sensorineural hearing loss (SSNHL). However, it makes a glycemic control worse in patients with diabetes. Intratympanic steroid injection (ITSI) can result in reduced systemic steroid toxicity and higher perilymph steroid level selectively. The purpose of this study is to compare the efficacy of ITSI (IT group) with that of systemic steroid (IV group) on SSNHL with diabetes. Subjects and Method：Thirty eight SSNHL patients who were diagnosed with diabetes were divided into the IV group (19 patients) and the IT group (19 patients). In the IV group, prednisolone was administrated intravenously for 7 days followed by tapered doses orally for 7 days. In the IT group, dexamethasone was administrated 4 times within a 2 week-period. Hearing outcome was assessed before and after treatment. Results：In the IV group, 10 patients (58.8%) showed an improvement in the pure tone audiogram (PTA), with a mean improvement of 17.6 dB (p=0.023). In the IT group, 16 patients (84.2%) showed improvement in the PTA, with the mean improvement of 25.1 dB (p=0.000). But there was no significant difference in hearing gain and the recovery rate between the two groups. And it is more difficult to control blood sugar in the IV group rather than in the IT group. Conclusion：ITSI treatment is as effective as the systemic steroid treatment for SSNHL patients with diabetes and it can avoid a significant side effect of systemic steroids. So it could be considered as an initial treatment for the SSNHL patient with diabetes. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:227-33)

#Sudden hearing loss·Diabetes·Intratympanic steroid injection.

참고문헌 (22)

참고문헌 신청

Alles MJ / 2006 / Intratympanic steroid therapy for inner ear disease, a review of the literature / Eur Arch Otorhinolaryngol 263 (9) : 791 ~ 797

Chandrasehkar SS / 2001 / Intratympanic dexamthasone for sudden sensorineural hearing loss: Clinical and laboratory evaluation / Otol Neurotol 22 (1) : 18 ~ 23

Choung YH / 2006 / Intratympanic dexamethasone injection for refractory sudden sensorineural hearing loss / Laryngoscope 116 (5) : 747 ~ 752

Costa OA / 1967 / Inner ear pathology in experimental diabetes / Laryngoscope 77 (1) : 68 ~ 75

Fetterman BL / 1996 / Prognosis and treatment of sudden sensorineural hearing loss / Am J Otol 17 (4) : 529 ~ 536

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