Estudio comparativo entre tratamiento convencional y el uso de la dexametasona intratimpánica en pacientes con hipoacusia súbita. Hospital Regional II IESS Dr. Teodoro Maldonado Carbo período 2010 -2011
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2011
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La hipoacusia súbita es una urgencia médica. Con este propósito se han empleado muchas opciones terapéuticas, todas con resultados controversiales. Actualmente se vienen utilizando corticoides intratimpánicos y los estudios disponibles muestran resultados variados. En el hospital Regional II del IESS “Dr. Teodoro Maldonado Carbo”, el tratamiento consiste en la administración sistémica de glucocorticoides, y no se cuenta con experiencia del uso de estos medicamentos aplicados directamente en el tímpano. Con el objetivo de evaluar el tratamiento con corticoides orales y el uso de la dexametasona intratimpánica para el manejo de hipoacusia súbita en el Servicio de Otorrinolaringología de esta institución, se realizó un estudio de tipo descriptivo correlacional, de diseño no experimental, longitudinal, prospectivo en el período comprendido entre el 1 de Mayo de 2010 al 31 de Agosto de 2011 en el que se compararon dos grupos de 25 pacientes cada uno con hipoacusia súbita que recibieron corticoides orales y dexametasona intratimpánica respectivamente. Para el análisis estadístico se emplearon la prueba de Homogeneidad de X2 y la prueba de Kolmogorov – Smirnov, y se consideraron significativos valores de P < 0.05. El análisis de riesgo se realizó calculando riesgo relativo (RR), la razón de exceso (OR) la reducción del riesgo relativo (RRR), el número de pacientes necesarios a tratar, (NPNT) y la reducción del riesgo absoluto (RRA). Con el uso de dexametasona intratimpánica se evidenció una reducción del riesgo absoluto de evolución clínica adversa (0,65) y de evolución audiométrica adversa (1,92). El riesgo relativo también se redujo para los mismos eventos (RR: 0,650 y RR 0,48), la razón de exceso también fue beneficiosa para el uso de este tratamiento (OR 0,27)
Sudden hearing loss is a medical emergency. For this purpose have been used many treatment options, all with controversial results. Currently Intratympanic steroids have been used, and available studies show mixed results. Teodoro Maldonado Carbo hospital, treatment consists of systemic administration of glucocorticoids, and no experience with the use of these medications applied directly to the eardrum. In order to evaluate treatment with oral corticosteroids and the use of intratympanic dexamethasone for sudden hearing loss management in the Department of Otolaryngology at this institution, we conducted a correlational descriptive study of non-experimental, longitudinal, prospective the period from May 1, 2010 to August 31, 2011 in which it purchased two groups of 25 patients each with sudden hearing loss who received oral corticosteroids and intratympanic dexamethasone respectively. For the statistical analysis used the X2 test of homogeneity and the Kolmogorov - Smirnov, and were considered significant at P <0.05. The risk analysis was performed by calculating relative risk (RR), the ratio of excess (OR) relative risk reduction (RRR), number of patients needed to treat (NPNT) and absolute risk reduction (ARR). With the use of intratympanic dexamethasone was shown a reduction in absolute risk of adverse clinical outcomes (0.65) and audiometric evolution adversa (1.92). The relative risk was also reduced to the same events (RR 0.650 and RR 0.48), the ratio of excess was also beneficial for the use of this treatment (OR 0.27)
Sudden hearing loss is a medical emergency. For this purpose have been used many treatment options, all with controversial results. Currently Intratympanic steroids have been used, and available studies show mixed results. Teodoro Maldonado Carbo hospital, treatment consists of systemic administration of glucocorticoids, and no experience with the use of these medications applied directly to the eardrum. In order to evaluate treatment with oral corticosteroids and the use of intratympanic dexamethasone for sudden hearing loss management in the Department of Otolaryngology at this institution, we conducted a correlational descriptive study of non-experimental, longitudinal, prospective the period from May 1, 2010 to August 31, 2011 in which it purchased two groups of 25 patients each with sudden hearing loss who received oral corticosteroids and intratympanic dexamethasone respectively. For the statistical analysis used the X2 test of homogeneity and the Kolmogorov - Smirnov, and were considered significant at P <0.05. The risk analysis was performed by calculating relative risk (RR), the ratio of excess (OR) relative risk reduction (RRR), number of patients needed to treat (NPNT) and absolute risk reduction (ARR). With the use of intratympanic dexamethasone was shown a reduction in absolute risk of adverse clinical outcomes (0.65) and audiometric evolution adversa (1.92). The relative risk was also reduced to the same events (RR 0.650 and RR 0.48), the ratio of excess was also beneficial for the use of this treatment (OR 0.27)
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Hipoacusia súbita, Corticoides, Estudio comparativo, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Dexametasona, Tratamiento convencional