Hunchaisri Niran, Chantapant Suprapol, Srinangyam Nongyouw
Department of Otolaryngology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand.
J Med Assoc Thai. 2010 Dec;93(12):1406-14.
The standard medical regimen for SSNHL is systemic steroid therapy. Unfortunately, some patients either do not or poorly respond to systemic steroids. Intratympanic administration of steroids has been suggested as an alternative to systemic therapy.
To determine if intratympanic dexamethasone injection (ITDI) is an effective treatment for sudden sensorineural hearing loss (SSNHL) in patients that systemic steroid treatment has failed.
A prospective, non-randomized, controlled study evaluated the hearing outcomes in 14 SSNHL patients treated with ITDI as compared with the outcome of seven patients not treated. Intratympanic dexamethasone was administered through a spinal needle under local anesthesia. ITDI was performed once every week for maximum of three sessions. Hearing was assessed immediately before the therapy and 4 weeks after the therapy.
Hearing improvement was documented in six of 14 patients (43%) who underwent ITDI compare to none of the seven patients (0%) in no ITDI group. However, this was not statistically significant (p = 0.055).
Intratympanic dexamethasone (ITDI) may have benefits for patients with SSNHL who failed systemic steroid therapy.
突发性聋（SSNHL）的标准医学治疗方案是全身用类固醇激素治疗。不幸的是，一些患者对全身用类固醇激素治疗无反应或反应不佳。鼓室内注射类固醇激素已被提议作为全身治疗的替代方法。
确定鼓室内注射地塞米松（ITDI）对全身类固醇激素治疗无效的突发性感音神经性聋（SSNHL）患者是否为一种有效的治疗方法。
一项前瞻性、非随机、对照研究评估了14例接受ITDI治疗的SSNHL患者的听力结果，并与7例未接受治疗的患者的结果进行比较。在局部麻醉下通过腰椎穿刺针进行鼓室内注射地塞米松。ITDI每周进行1次，最多进行3次。在治疗前和治疗后4周评估听力。
14例接受ITDI治疗的患者中有6例（43%）听力改善，而未接受ITDI治疗的7例患者中无一例（0%）听力改善。然而，这在统计学上无显著差异（p = 0.055）。
鼓室内注射地塞米松（ITDI）可能对全身类固醇激素治疗无效的SSNHL患者有益。
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