Liječenje iznenadne zamjedbene nagluhosti

master's thesis

• Title (english): Treatment of sudden sensorineural hearing loss
• Author: Evita Gošić
• Mentor: Andro Košec (mentor)
• Committee member: Jakov Ajduk (predsjednik povjerenstva)
• Committee member: Mihael Ries (član povjerenstva)
• Committee member: Andro Košec (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2022-09-02, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Iznenadna zamjedbena nagluhost vrsta je oštećenja sluha koja se prezentira naglo te označava hitno stanje u otorinolaringologiji. Osim zamjedbene nagluhosti, postoji i provodno te mješovito oštećenje sluha na koje treba misliti u diferencijalnoj dijagnozi. Zamjedbena nagluhost naziva se još i perceptivna, a problem je u senzornom ili neuralnom dijelu slušnog puta. Senzorni dio čini pužnica dok neuralni dio čini slušni živac.
Iznenadna zamjedbena nagluhost definira se kao gubitak sluha od 30 dB na najmanje tri susjedne frekvencije u vremenskom periodu od 72 sata. Etiologija ove bolesti je još uvijek predmet mnogih rasprava i istraživanja, no najčešće se dijeli na idiopatsku i sekundarnu. Idiopatska iznenadna zamjedbena nagluhost čini većinu slučajeva. Najzastupljenije teorije o etiologiji primarne zamjedbene nagluhosti su virusna, vaskularna te autoimuna. Sekundarna iznenadna zamjedbena nagluhost najčešće nastaje zbog novotvorina, cerebrovaskularnog inzulta ili zračenja. Iznenadna zamjedbena nagluhost može se pojaviti i u stanjima poput multiple skleroze, autoimunih bolesti labirinta, akustične traume ili kao posljedica uzimanja lijekova koji imaju ototoksično djelovanje.
Dijagnosticiranje iznenadne zamjedbene nagluhosti trebalo bi se napraviti u što kraćem vremenskom roku kako bi se što ranije započelo s liječenjem. Dijagnoza se temelji na dobroj i detaljnoj anamnezi, fizikalnom pregledu, akumetrijskim testovima te audiometrijskom testiranju. Iako radiološke pretrage nisu obavezne u inicijalnoj dijagnostici, preporuka ih je napraviti kako bi se isključili sekundarni uzroci u naznačenih asimetrija sluha kada bolesnik ima udružene rizične čimbenike ili dodatne simptome. Od presudne važnosti za bolji oporavak je što ranije krenuti s inicijalnom terapijom koja se temelji na primjeni kortikosteroida i hiperbarične oksigencijacijske terapije.

Abstract (english)

Sudden sensorineural hearing loss is a type of hearing impairment that presents with rapid onset and marks an emergency in otorhinolaryngology. In addition to sensorineural deafness, there is also conductive and mixed hearing impairment that should be considered in the differential diagnosis. Sensorineural hearing loss is also called perceptive, and the problem is in the sensory or neural part of the auditory pathway. The sensory part is the cochlea, while the neural part is the auditory nerve.
Sudden sensorineural hearing loss is defined as hearing loss of 30 dB in at least three contiguous frequencies in 72 hours. The etiology of this disease is still the subject of many debates and research but it is commonly divided into idiopathic and secondary. Idiopathic sudden sensorineural hearing loss accounts for the majority of cases. The most common theories about the etiology of primary hearing loss are viral, vascular, and autoimmune. Secondary sudden sensorineural hearing loss most often occurs due to neoplasms, stroke, or radiation. Sudden sensorineural hearing loss can also occur in conditions such as multiple sclerosis, autoimmune diseases of the labyrinth, acoustic trauma, or as a result of taking ototoxic medications.
Diagnosis of sudden sensorineural hearing loss should be done as soon as possible to start the treatment. The diagnosis is based on a good and detailed history, physical examination, and acumetric and audiometric testing. Although radiological tests are not mandatory in the initial diagnosis, they are recommended to rule out secondary causes in indicated hearing asymmetries when the patient has associated risk factors or additional symptoms. It is of crucial importance for better recovery to start as early as possible with the initial therapy based on the use of corticosteroids and hyperbaric oxygenation therapy.

• Keywords: iznenadna zamjedbena nagluhost; oštećenje sluha; terapija
• Keywords (english): sudden sensorineural hearing loss; hearing impairment; therapy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:177356
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-09 08:48:48