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1
Issues, indications, and controversies regarding intratympanic steroid perfusion.关于鼓室内类固醇灌注的问题、适应证及争议
Curr Opin Otolaryngol Head Neck Surg. 2008 Oct;16(5):434-40. doi: 10.1097/MOO.0b013e32830ce796.
2
Intratympanic dexamethasone and hyaluronic acid in patients with low-frequency and Ménière's-associated sudden sensorineural hearing loss.鼓室内注射地塞米松和透明质酸治疗低频及梅尼埃病相关的突发性感音神经性听力损失患者
Otol Neurotol. 2005 Sep;26(5):890-5. doi: 10.1097/01.mao.0000185050.69394.48.
3
Rate of tympanic membrane perforation after intratympanic steroid injection.鼓室内注射类固醇后鼓膜穿孔的发生率。
Am J Otolaryngol. 2017 Jan-Feb;38(1):21-25. doi: 10.1016/j.amjoto.2016.09.004. Epub 2016 Sep 28.
4
Dexamethasone inner ear perfusion by intratympanic injection in unilateral Ménière's disease: a two-year prospective, placebo-controlled, double-blind, randomized trial.鼓室内注射地塞米松内耳灌注治疗单侧梅尼埃病：一项为期两年的前瞻性、安慰剂对照、双盲、随机试验。
Otolaryngol Head Neck Surg. 2005 Aug;133(2):285-94. doi: 10.1016/j.otohns.2005.05.010.
5
Transtympanic perfusion: indications and limitations.经鼓膜灌注：适应证与局限性
Curr Opin Otolaryngol Head Neck Surg. 2004 Oct;12(5):378-83. doi: 10.1097/01.moo.0000134438.91734.38.
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Intratympanic steroid therapy for inner ear diseases, a review of the literature.鼓室内注射类固醇治疗内耳疾病：文献综述
Eur Arch Otorhinolaryngol. 2006 Sep;263(9):791-7. doi: 10.1007/s00405-006-0065-3. Epub 2006 May 25.
7
Comparison of intermittent intratympanic steroid injection and near-continual transtympanic steroid perfusion as salvage treatments for sudden sensorineural hearing loss.间歇性鼓室内类固醇注射与持续经鼓室类固醇灌注治疗突发性聋的疗效比较。
Laryngoscope. 2013 Sep;123(9):2264-9. doi: 10.1002/lary.23909. Epub 2013 Jun 26.
8
Intratympanic steroid perfusion for sudden sensorineural hearing loss.鼓室内注射类固醇治疗突发性感音神经性听力损失
Arch Otolaryngol Head Neck Surg. 2005 Aug;131(8):730-2. doi: 10.1001/archotol.131.8.730.
9
Simultaneous versus subsequent intratympanic dexamethasone for idiopathic sudden sensorineural hearing loss.鼓室内同时与序贯应用地塞米松治疗特发性突发性聋。
Otolaryngol Head Neck Surg. 2011 Dec;145(6):1016-21. doi: 10.1177/0194599811418169. Epub 2011 Aug 4.
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Validity of the Western blot immunoassay for heat shock protein-70 in associated and isolated immunorelated inner ear disease.免疫印迹法检测热休克蛋白70在伴发及孤立性免疫相关性内耳疾病中的有效性
Laryngoscope. 2002 Feb;112(2):304-9. doi: 10.1097/00005537-200202000-00019.

引用本文的文献

1
Randomized Phase Ib Clinical Trial of DB-020 Intratympanic Injections to Reduce High-Dose Cisplatin Ototoxicity.DB-020鼓室内注射以降低高剂量顺铂耳毒性的随机1b期临床试验。
J Clin Oncol. 2025 Jul;43(19):2155-2163. doi: 10.1200/JCO.24.00905. Epub 2025 May 22.
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The effectiveness of intratympanic injections with methylPREDnisolon versus placebo in the treatment of vertigo attacks in MENière's disease (PREDMEN trial): a study protocol for a phase-3 multicentre, double-blinded, randomised, placebo-controlled trial.鼓室内注射甲泼尼龙与安慰剂治疗梅尼埃病眩晕发作的疗效比较（PREDMEN 试验）：一项 3 期多中心、双盲、随机、安慰剂对照临床试验方案。
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Discriminant Analysis of the Prognostic Factors for Hearing Outcomes in Patients with Idiopathic Sudden Sensorineural Hearing Loss.特发性突发性聋患者听力预后的判别分析。
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Effects of intratympanic gentamicin and intratympanic glucocorticoids in Ménière's disease: a network meta-analysis.鼓室内庆大霉素和鼓室内糖皮质激素治疗梅尼埃病的效果：网状荟萃分析。
J Neurol. 2022 Jan;269(1):72-86. doi: 10.1007/s00415-020-10320-9. Epub 2021 Jan 2.
7
Intratympanic application of triamcinolone in sudden hearing loss-radiologic anatomy in cone beam CT and its' correlation to clinical outcome.鼓室内应用曲安奈德治疗突发性聋-锥形束 CT 的放射解剖及其与临床结果的相关性。
Eur Arch Otorhinolaryngol. 2020 Jul;277(7):1931-1937. doi: 10.1007/s00405-020-05920-0. Epub 2020 Mar 23.
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Evaluating the Efficacy of L-N-acetylcysteine and Dexamethasone in Combination to Provide Otoprotection for Electrode Insertion Trauma.评估L- N-乙酰半胱氨酸和地塞米松联合使用对电极插入创伤提供耳保护作用的疗效。
J Clin Med. 2020 Mar 6;9(3):716. doi: 10.3390/jcm9030716.
9
Intratympanic corticosteroids in Ménière's disease: A mini-review.梅尼埃病的鼓室内注射皮质类固醇：一篇小型综述。
J Otol. 2017 Sep;12(3):117-124. doi: 10.1016/j.joto.2017.06.002. Epub 2017 Jun 26.
10
Pharmacokinetic principles in the inner ear: Influence of drug properties on intratympanic applications.内耳的药代动力学原理：药物性质对鼓室内应用的影响。
Hear Res. 2018 Oct;368:28-40. doi: 10.1016/j.heares.2018.03.002. Epub 2018 Mar 11.

本文引用的文献

1
[Expression patterns of non-viral transfection with GFP in the organ of Corti in vitro and in vivo. Gene therapy of the inner ear with non-viral vectors].[绿色荧光蛋白在体外和体内柯蒂氏器中非病毒转染的表达模式。非病毒载体对内耳的基因治疗]
HNO. 2008 May;56(5):524-9. doi: 10.1007/s00106-008-1738-6.
2
Combination therapy (intratympanic dexamethasone + high-dose prednisone taper) for the treatment of idiopathic sudden sensorineural hearing loss.联合治疗（鼓室内注射地塞米松 + 大剂量泼尼松逐渐减量）用于治疗特发性突发性感音神经性听力损失。
Otol Neurotol. 2008 Jun;29(4):453-60. doi: 10.1097/MAO.0b013e318168da7a.
3
Immunodefense of the round window.圆窗的免疫防御。
Laryngoscope. 2008 Jun;118(6):1057-62. doi: 10.1097/MLG.0b013e31816b30b0.
4
AM-111 reduces hearing loss in a guinea pig model of acute labyrinthitis.AM - 111可减轻急性迷路炎豚鼠模型的听力损失。
Laryngoscope. 2007 Dec;117(12):2174-82. doi: 10.1097/MLG.0b013e3181461f92.
5
Dexamethasone concentration gradients along scala tympani after application to the round window membrane.将地塞米松应用于圆窗膜后，沿鼓阶的地塞米松浓度梯度。
Otol Neurotol. 2008 Apr;29(3):401-6. doi: 10.1097/MAO.0b013e318161aaae.
6
Intratympanic application of an antiviral agent for the treatment of Ménière's disease.鼓室内应用抗病毒药物治疗梅尼埃病。
ORL J Otorhinolaryngol Relat Spec. 2008;70(1):21-6; discussion 26-7. doi: 10.1159/000111044. Epub 2008 Feb 1.
7
The endocochlear potential depends on two K+ diffusion potentials and an electrical barrier in the stria vascularis of the inner ear.内耳蜗电位取决于两种钾离子扩散电位以及内耳血管纹中的一个电屏障。
Proc Natl Acad Sci U S A. 2008 Feb 5;105(5):1751-6. doi: 10.1073/pnas.0711463105. Epub 2008 Jan 24.
8
Effect of topical dexamethasone on sensorineural hearing loss in endotoxin-induced otitis media.局部用 dexamethasone 对内毒素诱导的中耳炎感音神经性听力损失的影响。
In Vivo. 2007 Nov-Dec;21(6):1043-7.
9
Longitudinal results with intratympanic dexamethasone in the treatment of Ménière's disease.鼓室内注射地塞米松治疗梅尼埃病的纵向研究结果
Otol Neurotol. 2008 Jan;29(1):33-8. doi: 10.1097/mao.0b013e31815dbafc.
10
In vitro permeability of round window membrane to transforming dexamethasone with delivery vehicles--a dosage estimation.圆窗膜对携带地塞米松的给药载体的体外渗透性——剂量估算
Chin Med J (Engl). 2007 Dec 20;120(24):2284-9.

关于鼓室内类固醇灌注的问题、适应证及争议

Issues, indications, and controversies regarding intratympanic steroid perfusion.

作者信息

Hamid Mohamed, Trune Dennis

机构信息

The Cleveland Hearing & Balance Center, Cleveland, Ohio 44122, USA.

出版信息

Curr Opin Otolaryngol Head Neck Surg. 2008 Oct;16(5):434-40. doi: 10.1097/MOO.0b013e32830ce796.

DOI:10.1097/MOO.0b013e32830ce796
PMID:18797285
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2664082/
Abstract

PURPOSE OF REVIEW

Office-based intratympanic inner ear steroid perfusion (ITPs) treatment for Ménière's disease, autoimmune inner ear disease, and sudden sensorineural hearing loss has been expanding over the past 10-15 years, yet remains controversial. The purpose of this review is to examine the current literature of basic science and human studies of ITPs treatment.

RECENT FINDINGS

Animal studies exist regarding the delivery, distribution, biochemical, and microbiological changes in the inner ear post ITPs. However, few clinical studies exist on ITPs treatment in sudden sensorineural hearing loss and even less in treating Ménière's disease. There are no consistent studies regarding drug delivery methods, type, and concentration of steroids. Moreover, there are no studies comparing ITPs results to the natural history of Ménière's disease.

SUMMARY

ITPs has impacted otology and neurotology practice due to increased utilization. A sound understanding of the basic science and clinical studies is needed to establish long-term efficacy of ITPs in controlling hearing loss in Ménière's disease by comparison to its natural history, as well as, potential application to other disorders.

摘要

综述目的

在过去10至15年中，基于门诊的鼓室内内耳类固醇灌注（ITP）治疗梅尼埃病、自身免疫性内耳疾病和突发性感音神经性听力损失的应用不断增加，但仍存在争议。本综述的目的是研究ITP治疗的基础科学和人体研究的当前文献。

最新发现

有关于ITP后内耳的给药、分布、生化和微生物学变化的动物研究。然而，关于ITP治疗突发性感音神经性听力损失的临床研究很少，用于治疗梅尼埃病的更少。关于药物给药方法、类固醇类型和浓度没有一致的研究。此外，没有将ITP结果与梅尼埃病自然病程进行比较的研究。

总结

由于使用增加，ITP已经影响了耳科学和神经耳科学的实践。需要对基础科学和临床研究有充分的了解，以便通过与梅尼埃病自然病程比较来确定ITP在控制梅尼埃病听力损失方面的长期疗效，以及其在其他疾病中的潜在应用。