Возможности терапии больных сенсоневральной тугоухостью на современном этапе

Свистушкин В.М., Ордян А.Б., Никифорова Г.Н. и др. Возможности терапии больных сенсоневральной тугоухостью на современном этапе. Consilium Medicum. 2020; 22 (11): 31–33. DOI: 10.26442/20751753.2020.11.200370

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Svistushkin V.M., Ordyan A.B., Nikiforova G.N. et al. Possibilities of therapy for patients with sensorineural hearing loss at the present stage. Consilium Medicum. 2020; 22 (11): 31–33. DOI: 10.26442/20751753.2020.11.200370

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Аннотация

Сенсоневральная тугоухость (СНТ) – распространенное заболевание, представляющее актуальную проблему оториноларингологии. Наиболее сложными и значимыми являются вопросы острой и внезапной СНТ. С каждым годом число больных, страдающих данной патологией, неуклонно растет. Увеличение количества случаев СНТ связывают с рядом социально-медицинских аспектов современной жизни: ростом соматической и иммунной патологии, частыми стрессами, высоким уровнем шума и вибрации, регулярным использованием наушников, ухудшением экологии и влиянием других неблагоприятных факторов. Широкое использование аудиометрических методов исследования способствует более точной диагностике нарушения звуковосприятия у пациентов разных возрастных групп, что также отражается на эпидемиологических данных. В связи с перечисленным изучение современных возможностей лечения пациентов с СНТ является актуальной задачей клинической медицины.

Ключевые слова: слуховая функция, сенсоневральная тугоухость, интратимпанальная инъекция, глюкокортикостероидная терапия, дексаметазон, метилпреднизолон.

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Sensorineural hearing loss is one of the common diseases and it represents an urgent problem of otorhinolaryngology. The most complex and significant issues are acute and sudden sensorineural hearing loss. Every year, the number of patients suffering from this pathology is steadily growing. The increase in the number of cases of sensorineural hearing loss is associated with a number of socio-medical aspects of human life at the present stage – the growth of somatic and immune pathology, frequent stresses, high noise and vibration levels, regular use of headphones, environmental degradation and the influence of other adverse factors. The widespread use of audiometric research methods contributes to a more accurate diagnosis of impaired sound in patients of various age groups, which also affects the epidemiological data. In connection with the above, the study of modern treatment options for patients with sensorineural hearing loss is an urgent problem of clinical medicine.

Key words: аcoustical function, sensorineural hearing loss, intratympanic therapy, glucocorticoid therapy, intratympanic injection, dexamethasone, methylprednisolone.

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Список литературы

1. Глухота и потеря слуха. Всемирная организация здравоохранения, 2019. https://www.who.int/ru/news-room/fact-sheets/detail/deafness-and-hearing-loss
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5. Kuhn M, Heman-Ackah SE, Shaikh JA, Roehm PC. Sudden Sensorineural Hearing Loss: A Review of Diagnosis, Treatment, and Prognosis. Trends Amplif 2011; 15 (3): 91–105. DOI: 10.1177/1084713811408349
6. Shirwany NA, Seidman MD, Tang W. Effect of transtympanic injection of steroids on cochlear blood flow, auditory sensitivity, and histology in the guinea pig. Am J Otol 1998; 19 (2): 230–5.
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8. Fitzgerald DC, McGuire JF. Intratympanic steroids for idiopathic sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 2007; 116 (4): 253–6. DOI: 10.1177/000348940711600405
9. Parnes LS, Sun AH, Freeman DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope 1999; 109 (7 Pt 2): 1–17. DOI: 10.1097/00005537-199907001-00001
10. Slattery WH, Fisher LM, Iqbal Z et al. Intratympanic steroid injection for treatment of idiopathic sudden hearing loss. Otolaryngol Head Neck Surg 2005; 133 (2): 251–9. DOI: 10.1016/j.otohns.2005.05.015
11. Banerjee A, Parnes LS. Intratympanic corticosteroids for sudden idiopathic sensorineural hearing loss. Otol Neurotol 2005; 26 (5): 878–81. DOI: 10.1097/01.mao.0000185052.07513.5a
12. Bird PA, Begg EJ, Zhang M et al. Intratympanic versus intravenous delivery of methylprednisolone to cochlear perilymph. Otol Neurotol 2007; 28 (8): 1124–30. DOI: 10.1097/MAO.0b013e31815aee21
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[Kosiakov S.Ia., Atanesian A.G., Gunenkov A.V. Mestnaia terapiia ostroi sensonevral'noi tugoukhosti putem intratimpanal'nogo vvedeniia steroidov. Vestn. otorinolaringologii. 2012; 3: 74–8 (in Russian).]
14. Masoumi E, Dabiri S, Ashtiani MTK et al. Methylprednisolone versus dexamethasone for control of vertigo in patients with definite Meniere’s disease. Iran J Otorhinolaryngol 2017; 29 (95): 341–46.
15. Berjis N, Soheilipour S, Musavi A, Hashemi S. Intratympanic dexamethasone injection vs methylprednisolone for the treatment of refractory sudden sensorineural hearing loss. Adv Biomed Res 2016; 5: 111. DOI: 10.4103/2277-9175.184277
16. Balough BJ. Intratympanic Dexamethasone for Sudden Sensorineural Hearing Loss After Failure of Systemic Therapy. Yearb Otolaryngol Neck Surg 2008.
17. Seggas I, Koltsidopoulos P, Bibas A et al. Intratympanic steroid therapy for sudden hearing loss: A review of the literature. Otol Neurotol 2011; 32 (1): 29–35. DOI: 10.1097/mao.0b013e3181f7aba3
18. El Sabbagh NG, Sewitch MJ, Bezdjian A, Daniel SJ. Intratympanic dexamethasone in sudden sensorineural hearing loss: A systematic review and meta-analysis. Laryngoscope 2017; 127 (8): 1897–908. DOI: 10.1002/lary.26394
19. Haynes DS, O'Malley M, Cohen S. Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy. Laryngoscope 2007; 117 (1): 3–15. DOI: 10.1097/01.mlg.0000245058.11866.15
20. Alexander TH, Harris JP, Nguyen QT, Vorasubin N. Dose effect of intratympanic dexamethasone for idiopathic sudden sensorineural hearing loss: 24 mg/mL is superior to 10 mg/mL. Otol Neurotol 2015; 36 (8): 1321–7. DOI: 10.1097/MAO.0000000000000834
21. Kiliç R., Safak MA, Oğuz H et al. Intratympanic methylprednisolone for sudden sensorineural hearing loss. Otol Neurotol 2007; 28 (3): 312–6. DOI: 10.1097/MAO.0b013e31802fba7a
22. Bhandari A, Jain S. Early intratympanic methylprednisolone in sudden SNHL: A frequency-wise analysis. Indian J Otolaryngol Head Neck Surg 2019; 71 (3): 390–95. DOI: 10.1007/s12070-019-01582-5
23. Dai Y, Lu L, Hou J et al. Intratympanic methylprednisolone perfusion as a salvage treatment for profound idiopathic sudden sensorineural hearing loss. J Laryngol Otol 2017; 131 (5): 404–10. DOI: 10.1017/S0022215117000548
24. Dallan I, De Vito A, Fatto B et al. Intratympanic methylprednisolone in refractory sudden hearing loss: A 27-patient case series with univariate and multivariate analysis. Otol Neurotol 2010; 31 (1): 25–30. DOI: 10.1097/MAO.0b013e3181c34f18
25. Tarkan Ö, Dağkıran M, Sürmelioğlu Ö et al. Intratympanic methylprednisolone versus dexamethasone for the primary treatment of idiopathic sudden sensorineural hearing loss. J Int Adv Otol 2018; 14 (3): 451–55. DOI: 10.5152/iao.2018.4871
26. Yang J, Huang L, Shi J et al. The effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 24 (13): 594–7.
27. Topf MC, Hsu DW, Adams DR et al. Rate of tympanic membrane perforation after intratympanic steroid injection. Am J Otolaryngol 2017; 38 (1): 21–5. DOI: 10.1016/j.amjoto.2016.09.004
28. Park SH, Park C, Seo JY et al. How long should patients remain in the supine treatment position after intratympanic dexamethasone injection? Laryngoscope 2014; 124 (12): 2807–10. DOI: 10.1002/lary.24872

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1. Глухота и потеря слуха. Всемирная организация здравоохранения, 2019. https://www.who.int/ru/news-room/fact-sheets/detail/deafness-and-hearing-loss
2. Клинические рекомендации. Сенсоневральная тугоухость у взрослых. 2016. Национальная медицинская ассоциация оториноларингологов. http://pro-audiologia.ru/images/pdf/tugouhost-u-vzroslyh.pdf
3. Schreiber BE, Agrup C, Haskard DO, Luxon LM. Sudden sensorineural hearing loss. Lancet 2010; 375 (9721): 1203–11. DOI: 10.1016/S0140-6736(09)62071-7
4. Parfenov V.A., Antonenko L.M. Neirosensornaia tugoukhost' v nevrologicheskoi praktike. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2017; 9 (2): 10–4 (in Russian).
5. Kuhn M, Heman-Ackah SE, Shaikh JA, Roehm PC. Sudden Sensorineural Hearing Loss: A Review of Diagnosis, Treatment, and Prognosis. Trends Amplif 2011; 15 (3): 91–105. DOI: 10.1177/1084713811408349
6. Shirwany NA, Seidman MD, Tang W. Effect of transtympanic injection of steroids on cochlear blood flow, auditory sensitivity, and histology in the guinea pig. Am J Otol 1998; 19 (2): 230–5.
7. Čvorović L, Eric D, Probst R, Hegemann S. Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss. Otol Neurotol 2008; 29 (4): 464–9. DOI: 10.1097/MAO.0b013e31816fdcb4
8. Fitzgerald DC, McGuire JF. Intratympanic steroids for idiopathic sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 2007; 116 (4): 253–6. DOI: 10.1177/000348940711600405
9. Parnes LS, Sun AH, Freeman DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope 1999; 109 (7 Pt 2): 1–17. DOI: 10.1097/00005537-199907001-00001
10. Slattery WH, Fisher LM, Iqbal Z et al. Intratympanic steroid injection for treatment of idiopathic sudden hearing loss. Otolaryngol Head Neck Surg 2005; 133 (2): 251–9. DOI: 10.1016/j.otohns.2005.05.015
11. Banerjee A, Parnes LS. Intratympanic corticosteroids for sudden idiopathic sensorineural hearing loss. Otol Neurotol 2005; 26 (5): 878–81. DOI: 10.1097/01.mao.0000185052.07513.5a
12. Bird PA, Begg EJ, Zhang M et al. Intratympanic versus intravenous delivery of methylprednisolone to cochlear perilymph. Otol Neurotol 2007; 28 (8): 1124–30. DOI: 10.1097/MAO.0b013e31815aee21
13. Kosiakov S.Ia., Atanesian A.G., Gunenkov A.V. Mestnaia terapiia ostroi sensonevral'noi tugoukhosti putem intratimpanal'nogo vvedeniia steroidov. Vestn. otorinolaringologii. 2012; 3: 74–8 (in Russian).
14. Masoumi E, Dabiri S, Ashtiani MTK et al. Methylprednisolone versus dexamethasone for control of vertigo in patients with definite Meniere’s disease. Iran J Otorhinolaryngol 2017; 29 (95): 341–46.
15. Berjis N, Soheilipour S, Musavi A, Hashemi S. Intratympanic dexamethasone injection vs methylprednisolone for the treatment of refractory sudden sensorineural hearing loss. Adv Biomed Res 2016; 5: 111. DOI: 10.4103/2277-9175.184277
16. Balough BJ. Intratympanic Dexamethasone for Sudden Sensorineural Hearing Loss After Failure of Systemic Therapy. Yearb Otolaryngol Neck Surg 2008.
17. Seggas I, Koltsidopoulos P, Bibas A et al. Intratympanic steroid therapy for sudden hearing loss: A review of the literature. Otol Neurotol 2011; 32 (1): 29–35. DOI: 10.1097/mao.0b013e3181f7aba3
18. El Sabbagh NG, Sewitch MJ, Bezdjian A, Daniel SJ. Intratympanic dexamethasone in sudden sensorineural hearing loss: A systematic review and meta-analysis. Laryngoscope 2017; 127 (8): 1897–908. DOI: 10.1002/lary.26394
19. Haynes DS, O'Malley M, Cohen S. Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy. Laryngoscope 2007; 117 (1): 3–15. DOI: 10.1097/01.mlg.0000245058.11866.15
20. Alexander TH, Harris JP, Nguyen QT, Vorasubin N. Dose effect of intratympanic dexamethasone for idiopathic sudden sensorineural hearing loss: 24 mg/mL is superior to 10 mg/mL. Otol Neurotol 2015; 36 (8): 1321–7. DOI: 10.1097/MAO.0000000000000834
21. Kiliç R., Safak MA, Oğuz H et al. Intratympanic methylprednisolone for sudden sensorineural hearing loss. Otol Neurotol 2007; 28 (3): 312–6. DOI: 10.1097/MAO.0b013e31802fba7a
22. Bhandari A, Jain S. Early intratympanic methylprednisolone in sudden SNHL: A frequency-wise analysis. Indian J Otolaryngol Head Neck Surg 2019; 71 (3): 390–95. DOI: 10.1007/s12070-019-01582-5
23. Dai Y, Lu L, Hou J et al. Intratympanic methylprednisolone perfusion as a salvage treatment for profound idiopathic sudden sensorineural hearing loss. J Laryngol Otol 2017; 131 (5): 404–10. DOI: 10.1017/S0022215117000548
24. Dallan I, De Vito A, Fatto B et al. Intratympanic methylprednisolone in refractory sudden hearing loss: A 27-patient case series with univariate and multivariate analysis. Otol Neurotol 2010; 31 (1): 25–30. DOI: 10.1097/MAO.0b013e3181c34f18
25. Tarkan Ö, Dağkıran M, Sürmelioğlu Ö et al. Intratympanic methylprednisolone versus dexamethasone for the primary treatment of idiopathic sudden sensorineural hearing loss. J Int Adv Otol 2018; 14 (3): 451–55. DOI: 10.5152/iao.2018.4871
26. Yang J, Huang L, Shi J et al. The effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 24 (13): 594–7.
27. Topf MC, Hsu DW, Adams DR et al. Rate of tympanic membrane perforation after intratympanic steroid injection. Am J Otolaryngol 2017; 38 (1): 21–5. DOI: 10.1016/j.amjoto.2016.09.004
28. Park SH, Park C, Seo JY et al. How long should patients remain in the supine treatment position after intratympanic dexamethasone injection? Laryngoscope 2014; 124 (12): 2807–10. DOI: 10.1002/lary.24872

Авторы

В.М. Свистушкин*, А.Б. Ордян, Г.Н. Никифорова, С.В. Морозова, В.Ф. Гергиев

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*svvm3@yandex.ru

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Valeriy M. Svistushkin*, Ani B. Ordyan, Galina N. Nikiforova, Svetlana V. Morozova, Vladimir F. Gergiev

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*svvm3@yandex.ru

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