Prostaglandin E1 in combination with hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss.
CONCLUSIONS
Prostaglandin E1 (PGE1) is less effective than stellate ganglion block (SGB) in the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) patients with severe hearing losses when used together with hyperbaric oxygen (HBO) therapy. In contrast with the systemic action of intravenous PGE1, SGB's localized vasodilating action may explain its advantage over intravenous PGE1.


OBJECTIVE
To investigate the effect of PGE1 plus HBO therapy on ISSNHL in comparison with that of SGB plus HBO therapy.


METHODS
We retrospectively analyzed 205 consecutive patients with ISSNHL (hearing levels > or = 40 dB; time from the onset of hearing loss to the start of treatment < or = 30 days). Ninety-five patients underwent intravenous PGE1 plus HBO therapy (PG group) and 110 underwent SGB plus HBO therapy (SGB group). Hearing recovery was evaluated by grade assessment and by hearing improvement compared to that in the unaffected contralateral ear.


RESULTS
The overall hearing outcome was not statistically different between the two groups. For patients with initial hearing levels <80 dB, the groups had roughly equivalent hearing outcomes, whereas in patients with initial hearing levels > or = 80 dB, the hearing improvement rate was significantly higher in the SGB group than in the PG group (53.0 +/- 5.0% vs 35.3 +/- 6.8%; p <0.05).
Suzuki
Hideaki
H
Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Japan. suzuhyde@med.uoeh-u.ac.jp
Fujimura
Takeyuki
T
Ikeda
Katsuhisa
K
Shiomori
Teruo
T
Udaka
Tsuyoshi
T
Ohbuchi
Toyoaki
T
Nagatani
Gunji
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000008:administration & dosage*; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000187:drug effects; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D003639:Hearing Loss, Sudden / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D007262:Infusions, Intravenous; D008297:Male; D008619:Mepivacaine; D008875:Middle Aged; D009407:Nerve Block; D013233:Stellate Ganglion / Q000187:drug effects*
D008619:Mepivacaine; D000527:Alprostadil