Idiopatik ani işitme kayiplarinda steroid tedavisi ile steroid ve hiperbarik oksijen kombine tedavisinin karşilaştirilmasi

Objective: Several studies have been conducted on the efficacy of single-drug steroids in the treatment of idiopathic sudden hearing loss, as well as recent studies of hyperbaric oxygen therapy (HBOT). In this study, hyperbaric oxygen therapy was added to steroid treatment with steroid treatment only in patients with idiopathic sudden hearing loss. Material and Methods: Our study was performed with 85 patients who retrospectively applied to the polyclinic of Otorhinolaryngology Department of Dicle University Faculty of Medicine between January 2010 and April 2017 and were hospitalized due to sudden hearing loss in our clinic. Patients aged 16-76 years with at least 30 dB sensorineural hearing loss holding at least 3 consecutive frequencies within 3 days of this study were included in the study. It was noted that between the onset of hearing loss and the start of treatment, there was not more than 1 month of wasting. Patients who did not have idiopathic sudden hearing loss (previous history of operation and history of acute or chronic otitis media, ototoxicity, retrocochlear pathology, perilymph fistula, acoustic trauma), pediatric patients, those with previously known Meniere's disease were not included in the study. Hearing losses according to the mean pure sound thresholds of 500, 1000, 2000, 4000 Hz frequency; Classified as mild (26-40 dB), moderate (41-55 dB), medium-forward (56-70 dB), forward (71-90 dB) and total or very advanced. Patients were classified according to pure voice audiogram type; The flat type (hearing losses that do not differ by more than 20 dB between the best and the worst hearing thresholds), the rising (hearing losses with frequencies of 250-500 Hz), the descending (hearing losses with frequencies between 4000-8000 Hz) there were four groups. In our study, patients were divided into 2 groups according to their treatment. Only patients who received steroid treatment and steroids were further classified as hyperbaric oxygen therapy. Pure sound averages were accepted as the average of pure sound threshold levels at 500 Hz, 1000 Hz and 2000 Hz. The Siegel criteria were used to evaluate treatment response. Findings: The treatment response of the groups was divided into groups as complete recovery, partial recovery, poor recovery and no improvement. 24 patients in 42 patients in the steroid group responded to treatment, 18 patients did not respond to treatment. In the steroid + hyperbaric oxygen group, 20 patients from 43 patients responded to treatment, 23 patients did not respond to treatment. There was no statistically significant correlation between disease groups and treatment response according to the statistical result of the Yates corrected chi-square test (P =0.445). Conclusion: In our study, hyperbaric oxygen therapy was given in combination with steroid treatment as primary treatment, hyperbaric oxygen therapy and corticosteroid combination therapy only based on the comparison of systemic steroid therapy. In our study, only 24 of the 42 patients responded to treatment with steroid treatment, 18 patients did not respond to treatment. 20 of the 43 patients in the group with hyperbaric oxygen and steroid combination responded to the treatment, 23 patients did not respond to treatment. According to the square-quadrant test, p value was found as 0,445 and there was no statistically significant difference between these two treatment groups. In our study, hyperbaric oxygen therapy was ineffective. but hyperbaric oxygen therapy appears to be effective in the literature. There are a lot of studies about this. The patient can be informed about hyperbaric oxygen therapy for sudden hearing loss, and the primer can be used for treatment or rescue treatment. Key words: Sudden hearing loss, HBOT, steroid treatment