突発性難聴に対するステロイド２クール療法

Abstract

Idiopathic sudden hearing loss is a cochlear type of hearing loss of unknown origin. Between 1996 and 2001, we treated 206 patients, 209 ears with sudden deafness. At our hospital, we have been applying high dose steroid therapy in such cases. In this retrospective study, we report the successful treatment of patients with sudden hearing loss following a second course of steroids. We divided patients into two groups: 46 patients, 47 ears receiving a second course therapy of steroids and 160 patients, 162 ears receiving a single course. An analysis of case report gave the following findings:1) There were no significant differences in age or gender distributions between two groups. However, sudden hearing loss in the second steroid therapy group was more severe than that in the single group.2) The second course of steroids caused liver function disorder, gastric colic, and elevated blood sugar, but these symptoms were reversible.3) Hearing prognosis in sudden deafness classified as Grade 4 at the initial examination was improved by a second course of steroid therapy.4) At the end of the first course of steroid therapy, 68 patients, 69 ears were diagnosed as showing no effects. In this group, 29 patients, 30 ears were treated by a second course of steroid therapy (group A) and 39 patients, 39 ears were treated without further steroid administration (group B). The rate of marked and fair improvement in group A was significantly higher than that of group B.These findings indicate that a second course of steroid therapy has a significant beneficial effect on hearing level improvement. Finally, a carefully planned second course of steroid therapy appears to be a safe and effective for inveterate sudden hearing loss.