Hipoacusia neurosensorial súbita, el gran dilema de la otorrinolaringología. Una revisión de la literatura
DOI:
https://doi.org/10.26820/recimundo/4.(4).noviembre.2020.40-61Palabras clave:
Auditiva, Hearing Loss, Sensorineural, Pérdida Auditiva, Súbita, SorderaResumen
Introducción La hipoacusia neurosensorial súbita es una emergencia otorrinolaringológica descrita desde 1944 y que continúa siendo un gran enigma. El objetivo es resumir e identificar los aspectos relevantes, avances y futuras perspectivas acerca del tema Metodología: Se realizó una revisión de literatura usando los motores de búsqueda de MEDLINE y Google académico de los últimos 5 años. Resultados: Es de causa idiopática en el 85% a 90%, con presentación bilateral en 0,4 a 3,4%, se han planteado numerosas teorías etiológicas entre ellas: vascular, inmunológica, estrés oxidativo, autoinmune, fístula perilinfática, traumáticas, viral, tumoral,entre otros, y en relación a ellas, numerosas líneas de tratamiento sin evidencia concluyente hasta el momento. Discusión: Frente a este cuadro clínico, se debe actuar inmediatamente; en el diagnóstico es importante la diferenciación con hipoacusia secundaria, la detección de signos de alarma, la forma de presentación y la severidad de la hipoacusia. No existe al momento un consenso global sobre su manejo, sin embargo, se recomienda iniciar con corticoterapia de manera inmediata, El uso de otras terapias aún se encuentra en debate, parecería tener evidencia prometedora el uso adyuvante con corticoides de vasodilatadores (PGE1), calcio antagonistas y acupuntura. La terapia de rescate parecería ser prometedora con el uso de oxígeno hiperbárico y corticoides intratimpánicos. Se han planteado otras terapias a futuro, buscando la estimulación de la regeneración de cilios celulares, o el reemplazo con células madre, sin embargo, estas terapias son conceptuales y aun no se han comprobado en estudios experimentales.Descargas
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