Eficácia da avaliação audiométrica no tratamento medicamentoso da otospongiose

Abstract

Ot ospongiosis is a primary osteodystrophy of the otic capsule that affects genetically predisposed individuals and leads to a progressive hearing loss. Aim:To evaluate the applicability of audiometric evaluation during drug treatment for otospongiosis. Materials and Methods:A prospective, randomized, controlled, double-blind study involving 26 patients with clinical, audiometric and CT scan image of otosclerosis. Patients eligible for the study were divided into three groups (A, B and C) and received treatment with alendronate sodium (B), sodium fluoride (C) and placebo (A) for 6 months. After this period they were submitted to new tests.Results: There were not statistically significant differences between air and bone conduction (gap). We also found no differences in the speech recognition threshold (SRT) and speech discrimination (IRF) between before and after treatment. Conclusion:After six months of drug treatment the audiometric evaluation kept the same hearing thresholds, suggesting stabilization of the otospongiotic lesions. Braz J Otorhinolaryngol. 2012;78(2):73-9. ORIGINAL ARTICLE BJORL

Limited Evidence for the Effect of Sodium Fluoride on Deterioration of Hearing Loss in Patients With Otosclerosis

“…Some of the studies included patients that underwent stapes surgery during the observation period (10,11,15,16) or did not use a placebo comparator (9Y13, 15,16). The risk of bias was moderate in 3 studies (8,10,14) and high in the other 6 (9,11Y13,15,16). Adequate randomization and concealed treatment assignment was not achieved in any of the studies (8Y16).…”

“…All 9 included articles were assessed on directness of evidence and risk of bias, as shown in Table 2. Three studies provided direct evidence (8,12,14), and in 6 studies, the directness was found low or moderate (9Y11, 13,15,16). Some of the studies included patients that underwent stapes surgery during the observation period (10,11,15,16) or did not use a placebo comparator (9Y13, 15,16).…”

“…Adequate randomization and concealed treatment assignment was not achieved in any of the studies (8Y16). In most of the included 9 studies, either a large amount of outcome data was missing (8,10,14), or it was unclear whether data were missing (9,11Y13,15,16). Standardization of treatment and blinding of outcome was achieved in only 3 studies (8,10,14).…”

“…In most of the included 9 studies, either a large amount of outcome data was missing (8,10,14), or it was unclear whether data were missing (9,11Y13,15,16). Standardization of treatment and blinding of outcome was achieved in only 3 studies (8,10,14). Two articles, with high directness of evidence and moderate risk of bias, represented the best available evidence and were included for further review (8,14).…”

Imaging Studies in Otosclerosis: An Up-to-date Comprehensive Review

“…In this context, evidence of demineralization of the cochlear endosteum in HRCT or MRI could support the use of drug therapy to prevent the onset or the progression of the disease, even in cases without audiometric repercussions. 53 Magnetic resonance imaging in particular might be a fair method for objective analysis of medical treatment in otosclerosis. In a controlled study, de Oliveira Vicente et al reported that both subjective and objective measures of signal intensity in the FAF on MRI could serve as parameters of effectiveness during the use of sodium fluoride or sodium alendronate.…”