鼓室内注射地塞米松或甲泼尼龙对突发性感音神经性听力损失的治疗效果

[The effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss].

作者信息

Yang Jun, Huang Li, Shi Jun, Li Yun, Wu Hao, Kong Weijia

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Jul;24(13):594-7.

DOI:

PMID:20842947

Abstract

OBJECTIVE

To investigate the effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss.

METHOD

Forty-seven subjects received an at least 7-day dexamethasone(5 g/L/d) or methylprednisolone (40 g/L/d) course. Pure-tone averages (PTA) of pre-injection and post-injection at 4-frequency (500, 1,000, 2,000, 4,000 Hz) were compared. More than 10 dB HL of improvement in PTA was considered to be clinically significant.

RESULT

PTA of pre-injection and post-injection were (71.59 +/- 27.66) dB HL and (53.44 +/- 30.10) dB HL respectively in 24 patients with intratympanic dexamethasone. There was significant improvement in PTA (P<0.01), 1.67% of patients showed improvement in hearing. PTA of preinjection and post-injection were (68.64 +/- 25.21) dB HL and (55.76 +/- 26.42) dB HL respectively in 23 patients with intratympanic methylprednisolone. There was significant improvement in PTA (P<0.01), 43% of patients showed improvement in hearing. There was no significant difference in PTA between intratympanic dexamethasone and methylprednisolone. After dexamethasone injection, evident improvement was accomplished in 11 cases who underwent treatment with other therapy (systemic steroids, vasodilator agent, or high-pressure-oxygen therapy) (P<0.05); PTA showed significant improvement in 13 cases with only intratympanic dexamethasone(P< 0.05). After methylprednisolone injection, evident improvement was accomplished in 17 cases who underwent treatment with other therapy (P<0.01); PTA decreased but had no significance in 6 cases with only intratympanic methyl-prednisolone(P>0.05). No unexpected adverse events such as otitis media, perforated tympanic membrane and worsening in hearing occurred during the injection or follow-up period.

CONCLUSION

Intratympanic dexamethasone or methylprednisolone can be beneficial in treatment on patient with sudden sensorineural hearing loss, however, there was no significant difference in the effect between dexamethasone and methylprednisolone. Dexamethasone is recommended to use as favorable drug for intratympanic application that could be primary therapy in treatment on sudden sensorineural hearing loss.

摘要

目的

探讨鼓室内注射地塞米松或甲泼尼龙治疗突发性感音神经性听力损失的效果。

方法

47例受试者接受了为期至少7天的地塞米松（5 g/L/d）或甲泼尼龙（40 g/L/d）疗程。比较注射前和注射后4个频率（500、1000、2000、4000 Hz）的纯音平均听阈（PTA）。PTA改善超过10 dB HL被认为具有临床意义。

结果

24例接受鼓室内注射地塞米松的患者，注射前和注射后的PTA分别为（71.59±27.66）dB HL和（53.44±30.10）dB HL。PTA有显著改善（P<0.01），1.67%的患者听力有改善。23例接受鼓室内注射甲泼尼龙的患者，注射前和注射后的PTA分别为（68.64±25.21）dB HL和（55.76±26.42）dB HL。PTA有显著改善（P<0.01），43%的患者听力有改善。鼓室内注射地塞米松和甲泼尼龙后的PTA无显著差异。注射地塞米松后，11例接受其他治疗（全身用类固醇、血管扩张剂或高压氧治疗）的患者有明显改善（P<0.05）；仅接受鼓室内注射地塞米松的13例患者PTA有显著改善（P<0.05）。注射甲泼尼龙后，17例接受其他治疗的患者有明显改善（P<0.01）；仅接受鼓室内注射甲泼尼龙的6例患者PTA下降但无统计学意义（P>0.05）。在注射期间或随访期间未发生中耳炎、鼓膜穿孔和听力恶化等意外不良事件。