RESUMO
Corticosteroid treatment has been considered the most effective treatment modality for sudden sensorineural hearing loss so far. Application route of corticosteroids may vary. We have designed a prospective randomized case-controlled clinical trial to evaluate the effectivenesses of the different application routes of steroids in the treatment of SSHL. Thirty-five patients were distributed randomly to two groups which were treated with either 'oral' or 'intratympanic' corticosteroids. Intratympanic steroid administration was performed three times every other day transtympanically. At the end of third month, recovery rate in the 'intratympanic' group was 84.2%, whereas in the 'oral' group, it was 87.5%. The difference between the recovery rates was not statistically significant. There were no major complications related to transtympanic steroid administration. These findings support that intratympanic steroid therapy is an alternative to systemic steroid therapy in the initial treatment of sudden hearing loss. In addition, transtympanic technique is an easy to perform and safe method for delivering steroids into the inner ear.
Assuntos
Administração Oral , Glucocorticoides , Perda Auditiva Neurossensorial , Perda Auditiva Súbita , Injeção Intratimpânica/métodos , Adulto , Audiometria de Tons Puros/métodos , Feminino , Glucocorticoides/administração & dosagem , Glucocorticoides/efeitos adversos , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Súbita/diagnóstico , Perda Auditiva Súbita/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do TratamentoRESUMO
The aim of this study was to demonstrate the differences between adult and pediatric tracheotomies in terms of indications, early and late complications and decannulation time. A total of 136 (53 children, 83 adult) patients who underwent tracheotomy between 2006 and 2011 were studied. Prolonged intubation was the most common indication in children (84.9%), whereas in the adult group, upper airway obstruction (45.8%) was the main indication. Early and late complication rates in children were 22.6% and 5.7%, respectively. Complication rates (early 19.3%, late 4.8%) in adults did not differ statistically from those in children. Similar decannulation success was observed in children (34.6%) and adults (40.2%). Mean decannulation times after tracheotomy were 317 and 69 days in children and adults, respectively, and the difference was statistically significant (p = 0.040). Pediatric and adult tracheotomies differ in terms of indication and decannulation time, but complications are similar.
