静脉治疗失败后鼓室内注射类固醇治疗突发性听力损失
Intratympanic steroids for treatment of sudden hearing loss after failure of intravenous therapy.
作者信息
Plaza Guillermo, Herráiz Carlos
机构信息
Otolaryngology Department, Hospital de Fuenlabrada, Madrid, Spain.
出版信息
Otolaryngol Head Neck Surg. 2007 Jul;137(1):74-8. doi: 10.1016/j.otohns.2007.01.022.
OBJECTIVE
We sought to describe our experience with intratympanic steroid treatment of sudden sensorineural hearing loss after failure of intravenous steroid treatment.
STUDY DESIGN AND SETTING
We conducted a nonrandomized prospective clinical trial. Fifty patients presenting with sudden onset idiopathic hearing loss were treated intravenously over five days. After this period, patients with treatment failure (18 cases) were offered intratympanic steroid treatment. Nine patients refused, whereas the other nine patients received three weekly injections of methylprednisolone. Recovery of hearing was reported as improvement of more than 15 dB in pure tone average.
RESULTS
Intratympanic steroid treatment improved hearing loss in five patients (55%). This is significant compared with those patients who refused intratympanic treatment, who showed no further improvement (P < 0.05). No serious adverse effects were observed.
CONCLUSION
Intratympanic steroids significantly improve the recovery outcome of sudden hearing loss that had not recovered after intravenous steroid treatment.
SIGNIFICANCE
Intratympanic steroids are an effective and safe therapy in sudden sensorineural hearing loss cases that are refractory to standard treatment.
目的
我们试图描述在静脉注射类固醇治疗失败后，鼓室内注射类固醇治疗突发性感音神经性听力损失的经验。
研究设计与背景
我们进行了一项非随机前瞻性临床试验。50例突发性特发性听力损失患者接受了为期五天的静脉注射治疗。在此期间后，治疗失败的患者（18例）接受鼓室内类固醇治疗。9例患者拒绝，而其他9例患者接受了每周三次的甲基强的松龙注射。听力恢复定义为纯音平均听阈提高超过15dB。
结果
鼓室内类固醇治疗使5例患者（55%）的听力损失得到改善。与拒绝鼓室内治疗且无进一步改善的患者相比，这一结果具有显著性差异（P<0.05）。未观察到严重不良反应。
结论
鼓室内类固醇显著改善了静脉注射类固醇治疗后未恢复的突发性听力损失的恢复结果。
意义
鼓室内类固醇在对标准治疗难治的突发性感音神经性听力损失病例中是一种有效且安全的治疗方法。
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