Hearing function after betahistine therapy in patients with Ménière's disease

ABSTRACT INTRODUCTION: Preventing or reversing hearing loss is challenging in Ménière's disease. Betahistine, as a histamine agonist, has been tried in controlling vertigo in patients with Ménière's disease, but its effectiveness on hearing problems is not known. OBJECTIVE: To examine the effect of betahistine on hearing function in not-previously-treated patients with Ménière's disease and to define possible contributors in this regard. METHODS: A total of 200 not-previously-treated patients with definite unilateral Ménière's disease received betahistine by mouth (initial dose, 16 mg three times a day; maintenance dose, 24-48 mg daily in divided doses). Changes in indicators of hearing status before and six months after treatment were documented. Hearing loss was considered as the mean hearing level >25 dB HL at five frequencies. RESULTS: The mean duration of disease was 3.37 years. Six months after treatment the mean hearing level decreased by 6.35 dB compared to that at the baseline (p < 0.001). Both patients' age and the duration of disease correlated negatively with the improvement in hearing function. Post treatment hearing loss was independently associated with age, the initial hearing level and the chronicity of disease. The corresponding optimal cut-off points for predicating a persistent hearing loss 6 months after treatment were 47 years, 38 dB HL, and 1.4 years, respectively. CONCLUSION: Oral betahistine was significantly effective in preventing/reversing hearing deterioration in patients with Ménière's disease. Age, the hearing level on admission, and the disease duration were independent predictors of hearing status after treatment.

摘要与引言：梅尼埃病（Ménière's disease）患者的听力损失预防或逆转颇具挑战。倍他司汀（betahistine）作为组胺激动剂（histamine agonist），已被尝试用于控制梅尼埃病患者的眩晕症状，但其对听力问题的疗效尚不明确。
研究目的：探讨倍他司汀对既往未接受治疗的梅尼埃病患者听力功能的影响，并明确该方面的潜在影响因素。
研究方法：共计200例确诊为单侧梅尼埃病且既往未接受治疗的患者，接受口服倍他司汀治疗（初始剂量为16mg，每日3次；维持剂量为每日24~48mg，分次服用）。记录治疗前与治疗6个月后听力状态相关指标的变化情况。听力损失定义为5个频率的平均听阈＞25dB HL。
研究结果：患者的平均病程为3.37年。治疗6个月后，平均听阈较基线水平下降6.35dB（p＜0.001）。患者年龄与病程均与听力功能改善呈负相关。治疗后听力损失与患者年龄、初始听阈水平及疾病慢性程度呈独立相关。预测治疗6个月后仍存在持续性听力损失的最佳临界值分别为47岁、38dB HL及1.4年。
研究结论：口服倍他司汀可显著预防或逆转梅尼埃病患者的听力恶化，患者年龄、入院时听阈水平及病程均为治疗后听力状态的独立预测因素。