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.
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。
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