突发性感音神经性聋伴饮酒患者鼓室内注射类固醇治疗的听力学结局及相关临床指标
Audiological outcomes and related clinical indicators of intratympanic steroid injection therapy in patients with sudden sensorineural hearing loss and alcohol consumption.
文献信息
| PMID | 42790176 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Shih-Lung Chen |
| 作者单位 | Department of Otorhinolaryngology & Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Biomedical Engineering, College of Engineering, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: rlong289@gmail.com. |
| 期刊 | American journal of otolaryngology |
| SCI 分区 | Q2 |
| IF | 1.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 突发性感音神经性聋（SSNHL）是一种急性耳科疾病，其临床表现异质，听力恢复结局多样。饮酒被认为可引起血管和代谢改变，可能影响内耳功能；然而，其对鼓室内注射类固醇（ITSI）后听力结局的影响仍不明确。本研究旨在评估接受ITSI治疗的伴饮酒SSNHL患者的听力学结局，并识别与听力恢复相关的因素。
方法： 这项回顾性研究分析了在一家三级医疗中心接受ITSI治疗的103例伴主动饮酒的SSNHL患者。饮酒量根据报告的每日啤酒瓶数进行量化。患者被分为≤1瓶/天和>1瓶/天两组。在ITSI前后评估听力学结局，并根据Siegel标准对听力恢复进行分类。采用单因素和多因素logistic回归模型检验与听力恢复相关的因素。
结果： 患者平均年龄为52.66 ± 15.41岁，平均听力水平增益为15.62 ± 19.15 dB，SRT增益为15.93 ± 29.83 dB，SDS增益为17.98 ± 33.46%。29例（28.16%）达到完全或部分恢复。未观察到饮酒水平与听力增益或恢复率之间存在显著关联。在单因素分析中，耳鸣、眩晕、耳闷胀感、较高的HbA1c水平以及重度听力图构型是听力恢复较差的显著预测因素。多因素分析显示，眩晕（OR = 0.1732）、耳闷胀感（OR = 0.1832）、HbA1c升高（OR = 0.1661）以及重度纯音测听模式（OR = 0.0419）仍与听力恢复几率降低独立相关。
结论： 在伴饮酒的SSNHL患者中，ITSI与多个听力参数的总体听力学改善相关。预后似乎与临床特征、代谢状态和听力图构型更密切相关。因此，仔细评估这些变量可能有助于临床医生对该患者群体进行风险分层、预后咨询以及制定更个体化的管理策略。
英文摘要
BACKGROUND: Sudden sensorineural hearing loss (SSNHL) is an acute otologic disorder with heterogeneous clinical presentations and diverse hearing recovery outcomes. Alcohol consumption has been implicated in vascular and metabolic alterations that may affect inner ear function; however, its influence on hearing outcomes following intratympanic steroid injection (ITSI) remains unclear. This study aimed to evaluate the audiological outcomes and identify factors associated with hearing recovery in SSNHL patients with alcohol consumption treated with ITSI.
METHODS: This retrospective study analyzed 103 patients with SSNHL and active alcohol consumption who were treated with ITSI at a tertiary medical center. Alcohol intake was quantified based on the reported daily number of beer bottles consumed. Patients were stratified into ≤1 bottle/day and >1 bottle/day groups. Audiological outcomes were evaluated before and after ITSI, and hearing recovery was categorized according to Siegel's criteria. Factors associated with hearing recovery were examined using univariate and multivariate logistic regression models.
RESULTS: The average age of the patients was 52.66 ± 15.41 years, with mean gains of 15.62 ± 19.15 dB in mean hearing level, 15.93 ± 29.83 dB in SRT, and 17.98 ± 33.46% in SDS. Complete or partial recovery was achieved in 29 patients (28.16%). No significant association was observed between alcohol consumption level and either hearing gains or recovery rates. Tinnitus, vertigo, aural fullness, higher HbA1c levels, and a profound audiometric configuration emerged as significant predictors of poorer hearing recovery in the univariate analysis. Multivariate analysis demonstrated that vertigo (OR = 0.1732), aural fullness (OR = 0.1832), elevated HbA1c (OR = 0.1661), and a profound pure-tone audiometry pattern (OR = 0.0419) remained independently associated with reduced odds of hearing recovery.
CONCLUSION: In patients with SSNHL and alcohol consumption, ITSI was associated with overall audiological improvement across multiple hearing parameters. Prognosis appeared to be more closely related to clinical characteristics, metabolic status, and audiometric configuration. Careful assessment of these variables may therefore assist clinicians in risk stratification, prognostic counseling, and the development of more individualized management strategies for this patient population.