Lautermann Jürgen, Sudhoff Holger, Junker Rüdiger
Department of Otorhinolaryngology, St. Elisabeth-Hospital, University of Bochum, Bleichstr. 15, 44787 Bochum, Germany.
Eur Arch Otorhinolaryngol. 2005 Jul;262(7):587-91. doi: 10.1007/s00405-004-0876-z. Epub 2005 Mar 3.
The prognosis of idiopathic sudden hearing loss depends on its severity; acute complete deafness, for example, has a particularly bad prognosis. The treatment of acute deafness is based on a systemic application of corticosteroids. Corticoid concentrations in the cochlea are higher after transtympanic application in comparison to systemic application. We therefore investigated whether an additional transtympanic corticoid therapy gives an advantage over systemic standard therapy. We report on 27 patients with sudden idiopathic profound hearing loss or deafness who were treated in the Department of Otorhinolaryngology, University of Essen, Germany. Fourteen patients were treated with a rheologic infusion therapy with systemic prednisolone. Thirteen patients were treated additionally with methylprednisolone (Urbason) transtympanically through a ventilation tube. In the first group of patients who were treated with infusion therapy and corticoids systemically, three patients had good recovery of hearing. Another five patients had a partial recovery of hearing. The average hearing gain from 0.5-4 kHz was 15 dB. In the group of patients who were treated additionally with local corticoids, two patients reported a good recovery of hearing and another two patients only had a partial recovery of hearing. The average hearing gain in the above-mentioned frequency range was 11 dB. In our patients the additional transtympanic application of corticoids did not result in a significantly improved recovery of hearing in comparison to the patients treated with the standard therapy alone.
特发性突聋的预后取决于其严重程度；例如，急性完全性耳聋的预后特别差。急性耳聋的治疗基于全身应用皮质类固醇。与全身应用相比，经鼓膜应用后耳蜗中的皮质激素浓度更高。因此，我们研究了额外的经鼓膜皮质激素治疗是否比全身标准治疗更具优势。我们报告了27例特发性突发重度听力损失或耳聋患者，他们在德国埃森大学耳鼻喉科接受治疗。14例患者接受了全身泼尼松龙的流变学输注治疗。13例患者通过通气管经鼓膜额外接受甲泼尼龙（Urbason）治疗。在第一组接受输注治疗和全身皮质激素治疗的患者中，3例患者听力恢复良好。另外5例患者听力部分恢复。0.5 - 4 kHz的平均听力增益为15 dB。在额外接受局部皮质激素治疗的患者组中，2例患者报告听力恢复良好，另外2例患者仅听力部分恢复。上述频率范围内的平均听力增益为11 dB。在我们的患者中，与仅接受标准治疗的患者相比，额外经鼓膜应用皮质激素并未导致听力恢复明显改善。
