당뇨 환자에서 돌발성 감각신경성 난청의 고실 내 스테로이드 주입술, 전신 스테로이드 투여, 병합 스테로이드 치료의 비교

Abstract

Background and Objectives We investigated whether the intratympanic steroid injectionsmight be an effective initial treatment for sudden sensorineural hearing loss (SSNHL) in patientswith diabetes mellitus (DM). Subjects and Method We assessed a total of 167 patients with DM and SSNHL who visiteda tertiary referral otolaryngology department between January 2010 and April 2018. Fortytwopatients with DM and SSNHL received intratympanic steroid injections; 48 patients withDM and SSNHL received systemic steroid treatment; and 77 patients with DM and SSNHLreceived a combination of systemic and intratympanic treatment. Initial and post treatmenthearing levels and fasting blood sugar (FBS) were assessed, and correlations between hearinggain and the duration of DM, HbA1c, FBS were investigated. Results After steroid treatment, hearing levels were 38.87±25.35 dB in the intratympanicinjection group, 41.09±28.49 dB in the systemic steroid treatment group, and 47.81±27.12 dBin the combined treatment group. Final hearing levels and hearing gain in the three groups didnot differ significantly. FBS after treatment in the systemic steroid treatment and combinedsteroid treatment group worsened relative to the intratympanic injection group (202.00±9.40mg/dL to 326.63±7.85 mg/dL). FBS, duration of DM, and HbA1c levels did not affect the hearinggain in patients with DM and SSNHL. Conclusion Intratympanic steroid injections are comparable to the systemic steroid treatmentmodality for SSNHL in patients with DM. Thus, intratympanic steroid injections mayserve as an effective initial treatment modality for SSNHL in patients with DM.