Volumen 66, Broj 1 VOJNOSANITETSKI PREGLED Strana 35 Correspondence to: Ljiljana Čvorović, Kliničko bolnički centar, Odeljenje za otorinolaringologiju i maksilofacijalnu hirurgiju, Ul Vukova br. 9, 11 080 Beograd, Srbija. +381 11 138 99 24. E-mail: ljiljanamil@sezampro.rs ORIGINALNI Č L A N A K UDC: 616.28-008.14-08 Da li je akutna senzorineuralna nagluvost hitno stanje? Does acute sensorineural deafness befall to urgent conditions? Ljiljana Čvorović*, Dragoslava Đerić † , Ljubomir Pavićević ‡ , Rudolf Probst § , Stefan Hegemann § Kliničko bolnički centar “Zemun”, *Odeljenje za otorinolaringologiju i maksilofacijalnu hirurgiju, Beograd, Srbija; Klinički centar Srbije, † Institut za otorinolaringologiju i maksilofacijalnu hirurgiju, Beograd, Srbija; Vojnomedicinska akademija, ‡ Klinika za otorinolaringologiju, Beograd, Srbija; University Hospital Zurich, § Department of Otorhinolaryngology, Zurich, Switzerland Apstrakt Uvod/Cilj. Akutna idiopatska senzorineuralna nagluvost (AISNN) jedna je od najkontroverznijih tema u otologiji. Cilj istraživanja bio je da se utvrdi da li vreme započinjanja tera- pije ima ikakav efekat na bolji oporavak sluha kod AISNN. Metode. Studija je dizajnirana kao retrospektivno istraživanje elektronske baze podataka bolesnika Klinike za uho, nos i grlo, Univerzitetske bolnice u Cirihu, u jedanaestogodišnjem periodu od 1995. do 2006. Identifikovan je 541 bolesnik sa dijagnozom AISNN. U analiziranom periodu, bolesnici su le- čeni sedam dana inhalacijom karbogena (95% O 2 i 5% CO 2 ) i oralnim prednizolonom. Inicijalni gubitak sluha definisan je kao prosečni prag sluha u dB (PPS inicijalni) u 4 frekvence (0,5; 1; 2 i 4 kHz) zahvaćenog uha. Na isti način odreena je vrednost finalnog praga sluha nakon terapije (PPS finalni). Poboljšanje sluha definisano je na tri načina: apsolutno pobo- ljšanje sluha (dB) = PPS inicijalni – PPS finalni; relativno po- boljšanje sluha (%) = apsolutno poboljšanje / (PPS inicijalni – PPS drugog uva) × 100; značajnim oporavkom smatrao se finalni PPS ≤ 30 dB ili ukoliko je bio jednak sa PPS drugog uha. Rezultati. Prosečni apsolutni oporavak sluha bio je 15,1 dB, a prosečni relativni oporavak 47%. Tristotinejedan boles- nik (57%) imao je značajan oporavak, dok 228 (43%) nije. Meu bolesnicima koji su primili terapiju u prva 24 h od po- četka nagluvosti, značajan oporavak sluha imalo je 56% i nije postojala značajna razlika izmeu ove grupe bolesnika i grupe koja je primila terapiju posle 24 h, ali unutar sedam dana ( 2 = 0,007, DF = 1, p > 0,01). Zaključak. Na osnovu rezultata retrospektivne studije može se zaključiti da akutni gubitak sluha nije urgentno stanje i da terapiju nije potrebno započeti u prva 24 h, nego u prvih sedam dana. Ključne reči: sluh, senzornonervni gubitak; dijagnoza; lečenje; lečenje, ishod. Abstract Background/Aim. Idiopathic sudden sensorineural hearing loss (ISSHL) is one of the most controversial issues in otology. The aim of this study was to determine whether a delay in treatment has any influence on hearing recovery in ISSHL. Method. This study was designed as a retrospective evalua- tion of an electronic patient data base of the University Hos- pital Zürich from January 1995 to August 2006. Five hundred and forty one patients with a sudden hearing loss were identi- fied. The standard treatment was carbogen inhalation (95% O 2 and 5% CO 2 eight times per day in the duration of 30 min- utes) and prednisone orally (100 mg in one morning dose) for 7 days. Factor that was analyzed included the interval between the onset of symptoms and the beginning of the treatment. The initial hearing loss was described using the pure tone av- erage (PTA in dB) hearing level at 4 frequencies (0.5, 1, 2 and 4 kHz). Hearing gain was expressed either as absolute hearing gain (dB values from initial PTA minus dB values from final PTA) or as relative hearing gain (absolute hearing gain divided by initial PTA minus baseline PTA) × 100. Significant recov- ery of hearing was defined as the final PTA ≤ 30 dB (or same as PTA of the opposite ear). Results. An absolute hearing gain between the initial audiogram and the final audiogram was 15.1 dB. The mean relative hearing gain was 47%. Three hundred one (57%) patients had a significant recovery of hearing, and 228 (43%) had not. If the patients received treat- ment in the first 24 hours after onset of symptoms, then the rate of significant recovery was 56%, and no significant differ- ence existed between this group and the patients who received the therapy after 24 hours, but within seven days ( 2 = 0.007, DF = 1, p > 0.01). Conclusion. These results suggest that it is not critical to begin the treatment of ISSHL immediately as an emergency, but within seven days. Key words: hearing loss, sensorineural; diagnosis; therapy; treatment outcome.