Dallan I, Fortunato S, Casani A P, Panicucci E, Berrettini S, Lenzi R, Nacci A
ENT Unit, Azienda Ospedaliero Universitaria Pisana, Italy.
J Laryngol Otol. 2011 Oct;125(10):1004-8. doi: 10.1017/S0022215111001782. Epub 2011 Aug 2.
Sudden sensorineural hearing loss is a true audiological emergency, and its management is much discussed. Currently, no single therapy has been proven effective according to evidence criteria. Recently, intratympanic application of steroids has been increasingly used in refractory cases; however, it has only rarely been reported as first-line therapy.
Twenty consecutive patients with sudden sensorineural hearing loss treated between July 2008 and January 2010 were enrolled in this prospective, case-control study. Ten patients were treated with intratympanic steroids and 10 with systemic 'shotgun' therapy (including steroids, pentoxifylline, low molecular weight heparin and vitamin E). The two groups were homogeneous in all respects. Pure tone averages were assessed before and after treatment for both groups.
There were no statistically significant differences between the two groups.
Intratympanic steroids seem to offer a valid alternative to systemic therapy, with few risks, in sudden sensorineural hearing loss patients, and we recommend their use as first-line therapy.
突发性感音神经性听力损失是一种真正的耳科急症，其治疗方法备受讨论。目前，根据循证标准，尚无单一疗法被证明有效。近来，鼓室内应用类固醇在难治性病例中使用得越来越多；然而，作为一线治疗的报道却很少。
选取2008年7月至2010年1月间连续收治的20例突发性感音神经性听力损失患者，纳入这项前瞻性病例对照研究。10例患者接受鼓室内类固醇治疗，10例接受全身性“组合式”治疗（包括类固醇、己酮可可碱、低分子量肝素和维生素E）。两组在各方面均具有同质性。对两组患者治疗前后的纯音平均听阈进行评估。
两组之间无统计学显著差异。
对于突发性感音神经性听力损失患者，鼓室内类固醇似乎是全身性治疗的一种有效替代方法，风险较小，我们建议将其用作一线治疗。
