突発性難聴の自然治癒例と治療例との比較
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概要
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Although it is well known that some cases of sudden deafness heal spontaneously, there have been very few detailed studies on their clinical courses. The present study was made to clarify the difference in audiological findings and the the clinical course of sudden deafness between spontaneously healed cases and those of healed and non-healed cases by treatment.One hundred and eighteen patients of sudden deafness visited us within 10 days after the onset. Thirty eight cases of them healed spontaneously. Eighty cases were treated with steroid, stellate blockade and/or other drugs. Auditory and vestibular functions of these patients were almost daily examined. Data obtained were statistically examined using X2-test and the following results were obtained:1. Spontaneous healing of hearing impairment was achieved in two different groups, i. e. rapidly in one group within 10 days after the onset and rather slowly in another group within 15 days. Although effectiveness of early treatment has been emphasized, possibility of early spontaneous recovery must be taken into consideration in evaluation of the effect of treatment.2. If the initial audiogram shows upward slope (low tone loss), trough or horizontal type, favorable prognosis can be expected.3. Positive recruitment, Jerger types I or II are signs of good prognosis.4. Those cases having vestibular symptoms an downward slope, abrupt high tone drop and deaf type in the initial audiogram show difficult recovery.5. In some cases, the treatment appeared to facilitate the speed of healing.6. From these results, it is assumed that sudden deafness consists of two different kinds of morbidity; one is reversible type characterized by low tone loss without vestibular sumptoms and another is irreversible type characterized by high tone loss with vestibular symptoms.7. The incidence of spontaneous recovery is considered to be within the range of 32-55%. Therefore, a given treatment can not be evaluated as effective, unless the cure rate exceeds 50%.
- 社団法人 日本耳鼻咽喉科学会の論文
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