Ani İşitme Kaybı Olan Hastalarda Prognoz Üzerine Etkili Faktörlerin İncelenmesi

Ev aluation of Factors Effective on Prognosis in Patients with Sudden Hearing Loss Sudden sensorioneural hearing loss is one of the important illnesses that has to be managed immediately, however consensus about its treatment is not present. At its pathophysiology, causes like viral infection, vascular factors, labirinth membrane rupture and autoimmunity are thought to be responsible. Although macromolecules like steroids, vasodilatator drugs, plasma volume expanders and urografin are used at treatment, many new treatment modalities are tried. This study was performed in 37 patients with the diagnosis of sudden hearing loss admitted to Ondokuz Mayis University Faculty of Medicine Otorhinolaryngology Department between May 2003 and April 2006. Steroid (1 mg/kg oral), urografin (10 ml i.v. at first day, then 5 ml i.v.), reomakrodeks (500 ml i.v. infusion for 8 hours) and piracetam (2x6 g i.v. for 5 days) were given to all patients. Criteria determined by 'Sudden Deafness Research Team of the Japanese Ministry of Health and Welfare' were used in the evaluation of treatment results. When the treatment results were evaluated, it was seen that prognosis was bad in patients with total hearing loss and hearing loss involving low frequencies had a better prognosis. In the presence of tinnitus as a vestibulocochlear symptom, prognosis was better. Ani sensorinoral isitme kaybi acil mudahale edilmesi gereken, ancak henuz tani ve tedavisinde fikir birligine varilamamis, onemli hastaliklardan biridir. Patofizyolojide viral enfeksiyon, vaskuler patolojiler, labirent membran rupturu, otoimmunite gibi nedenler sorumlu tutulmaktadir. Tedavide steroidler, vazadilator ilaclar, plazma volum genisleticileri, urografin gibi makromolekuller kullanilmakla birlikte gun gectikce bircok yeni tedavi modaliteleri denenmektedir. Bu calisma Mayis 2003-Nisan 2006 tarihleri arasinda Ondokuz Mayis Universitesi Tip Fakultesi Kulak Burun Bogaz klinigine basvuran ve ani isitme kaybi tanisi ile tedavi edilen 37 hastada yapildi. Tum hastalara steroid (1 mg/kg, oral), urografin (ilk gun 10cc, dort gun 5 cc iv), reomakrodeks (500 cc/8 saat iv infuzyon) ve pirasetam (2x6 gr iv bes gun) verildi. Tedavi sonuclarinin degerlendirilmesinde 'Sudden Deafness Research Team of the Japanese Ministry of Health and Welfar' tarafindan belirlenen kriterler kullanildi. Tedavi sonuclari degerlendirildiginde total isitme kayipli hastalarda prognozun kotu, alcak frekanslari tutan isitme kayipli hastalarda ve vestibulokoklear semptomlardan tinnitus varliginda prognozun daha iyi oldugu gorulmustur.