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Abstract(s)
A surdez súbita neurossensorial idiopática é caracterizada por uma sensação de diminuição auditiva abrupta (instaurada em menos de 72 horas) que, quando mensurada através de audiograma, corresponde a uma perda de 30 ou mais decibéis em pelo menos 3 frequências consecutivas.
Até ao momento, a patofisiologia da surdez súbita neurossensorial idiopática não é conhecida apesar de várias teorias etiológicas terem vindo a ser apontadas, nomeadamente alterações vasculares, roturas membranares, agentes infeciosos e autoimunidade. Atendendo às diferentes etiologias apresentadas, o tratamento desta patologia também se apresenta sob controvérsia, sendo vários os agentes terapêuticos propostos com o objetivo final de recuperar a audição do paciente.
A corticoterapia sistémica é habitualmente considerada como terapêutica inicial no tratamento da surdez súbita neurossensorial idiopática, apesar de estudos mais recentes não comprovarem a sua total eficácia. A corticoterapia intratimpânica tem vindo a ser igualmente utilizada, tanto como terapêutica inicial isolada como combinada com corticoterapia sistémica, no entanto, é enquanto terapêutica de resgate que os resultados obtidos se têm mostrado mais consistentes, demonstrando um efeito claramente benéfico na recuperação auditiva dos pacientes. Mais recentemente, a oxigenoterapia hiperbárica tem apresentado resultados promissores quer como terapêutica inicial quer como terapêutica de resgate no tratamento da surdez súbita neurossensorial idiopática. Apesar dos resultados apresentados até ao momento, são necessários estudos com amostras populacionais maiores e metodologicamente melhor standardizados garantindo assim uma maior validade científica e aplicação clínica.
Com o seguinte trabalho, e após revisão bibliográfica cuidada, pretende-se realizar uma apresentação holística sobre o tema da surdez súbita neurossensorial idiopática dando, no entanto, maior ênfase às diferentes abordagens terapêuticas defendidas atualmente no tratamento desta patologia.
Idiopathic sudden sensorineural hearing loss is characterized by an abrupt (established in less than 72 hours) hearing loss that, when measured by audiogram, corresponds to a loss of 30 or more decibels in at least 3 consecutive frequencies. To date, the pathophysiology of idiopathic sudden sensorineural hearing loss is unknown, and several etiological theories have been pointed over time, namely vascular changes, membrane ruptures, infectious agents and autoimmunity. Given the different etiologies proposed, idiopathic sudden sensorineural hearing loss treatment also presents itself under controversy, and different therapeutic agents are currently presented, always aiming at the patient's auditory recovery. Systemic corticosteroids are usually considered as initial therapy in the treatment of idiopathic sudden sensorineural hearing loss, although more recent studies do not prove their full efficacy. Intratympanic corticosteroid therapy has also been used, both as initial therapy alone and combined with systemic corticosteroids, however it is as salvage therapy that the results obtained have been shown to be more consistent, demonstrating a clearly beneficial effect on auditory recovery of patients. More recently, hyperbaric oxygen therapy has shown promising results both as initial therapy and as salvage therapy in the treatment of idiopathic sudden sensorineural hearing loss. Despite the results presented so far, studies with larger population samples and methodologically better standardization are required, thus guaranteeing greater scientific validity and clinical application. With the following work, and after a careful bibliographical review, a holistic presentation on the idiopathic sudden sensorineural hearing loss theme is planned, giving greater emphasis to the different therapeutic approaches currently advocated in the treatment of this pathology.
Idiopathic sudden sensorineural hearing loss is characterized by an abrupt (established in less than 72 hours) hearing loss that, when measured by audiogram, corresponds to a loss of 30 or more decibels in at least 3 consecutive frequencies. To date, the pathophysiology of idiopathic sudden sensorineural hearing loss is unknown, and several etiological theories have been pointed over time, namely vascular changes, membrane ruptures, infectious agents and autoimmunity. Given the different etiologies proposed, idiopathic sudden sensorineural hearing loss treatment also presents itself under controversy, and different therapeutic agents are currently presented, always aiming at the patient's auditory recovery. Systemic corticosteroids are usually considered as initial therapy in the treatment of idiopathic sudden sensorineural hearing loss, although more recent studies do not prove their full efficacy. Intratympanic corticosteroid therapy has also been used, both as initial therapy alone and combined with systemic corticosteroids, however it is as salvage therapy that the results obtained have been shown to be more consistent, demonstrating a clearly beneficial effect on auditory recovery of patients. More recently, hyperbaric oxygen therapy has shown promising results both as initial therapy and as salvage therapy in the treatment of idiopathic sudden sensorineural hearing loss. Despite the results presented so far, studies with larger population samples and methodologically better standardization are required, thus guaranteeing greater scientific validity and clinical application. With the following work, and after a careful bibliographical review, a holistic presentation on the idiopathic sudden sensorineural hearing loss theme is planned, giving greater emphasis to the different therapeutic approaches currently advocated in the treatment of this pathology.
Description
Keywords
Corticoterapia Intratimpânica Corticoterapia Sistémica Oxigenoterapia Hiperbárica Surdez Súbita Neurossensorial Idiopática Tratamento