An Yong-Hwi, Yu Kwang-Kyu, Kwak Min Young, Yoon Sang Won, Shim Hyun Joon
Department of Otorhinolaryngology-Head and Neck Surgery, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
Otol Neurotol. 2014 Sep;35(8):1330-7. doi: 10.1097/MAO.0000000000000526.
To determine the prognostic factors for the outcomes of treating acute subjective tinnitus with intratympanic dexamethasone (ITD).
Retrospective chart review.
Tertiary referral center.
We enrolled 139 subjects who were treated with ITD for acute subjective tinnitus with symptoms lasting for 3 months or less. Overall, 114 of 139 subjects completed questionnaires 3 months after treatment or fully recovered within 3 months. Audiograms were performed 3 months after treatment in 43 patients.
ITD for acute subjective tinnitus.
Quantitative assessment of the severity of tinnitus by questionnaires and changes in hearing thresholds at all frequencies by pure-tone audiometry.
Tinnitus was cured in 43 of 114 patients (37.7%) within 3 months. The mean tinnitus loudness score, the mean tinnitus awareness score, and the mean tinnitus handicap inventory score were significantly reduced at 3 months after ITD. Audiometric responses were detected in 12 of 43 patients (27.9%) who underwent follow-up audiograms. The cure rate was significantly greater in patients with symptoms lasting for 2 weeks or less than in patients with symptoms lasting for more than 1 month (64.7% vs. 15.7%; p < 0.05). The mean global improvement index for tinnitus was significantly greater in patients with unilateral tinnitus than in patients with bilateral tinnitus (6.2 ± 1.9 vs. 5.0 ± 2.0; p < 0.05). Among patients with unilateral tinnitus, the audiometric response rate was significantly greater in patients with asymmetric hearing threshold than in patients with symmetric hearing threshold (48.8% vs. 4.8%; p < 0.01). The cure rate was significantly associated with the duration of symptoms. Unilateral tinnitus and audiologic asymmetry were positively associated with the audiometric response rate.
The duration of symptoms affected the cure rate of ITD for acute subjective tinnitus. Unilateral tinnitus was associated with better improvements in symptoms than bilateral tinnitus. Furthermore, unilateral tinnitus and audiologic asymmetry were positively associated with the audiometric response.
确定鼓室内注射地塞米松（ITD）治疗急性主观性耳鸣疗效的预后因素。
回顾性病历审查。
三级转诊中心。
我们纳入了139例因急性主观性耳鸣接受ITD治疗且症状持续3个月或更短时间的受试者。总体而言，139例受试者中有114例在治疗3个月后完成问卷调查或在3个月内完全康复。43例患者在治疗3个月后进行了听力图检查。
ITD治疗急性主观性耳鸣。
通过问卷调查对耳鸣严重程度进行定量评估，以及通过纯音听力测定法评估所有频率的听力阈值变化。
114例患者中有43例（37.7%）在3个月内耳鸣治愈。ITD治疗3个月后，平均耳鸣响度评分、平均耳鸣知晓度评分和平均耳鸣残障量表评分均显著降低。43例接受随访听力图检查的患者中有12例（27.9%）检测到听力测定反应。症状持续2周或更短时间的患者治愈率显著高于症状持续超过1个月的患者（64.7%对15.7%；p<0.05）。单侧耳鸣患者的耳鸣总体改善指数显著高于双侧耳鸣患者（6.2±1.9对5.0±2.0；p<0.05）。在单侧耳鸣患者中，听力阈值不对称的患者听力测定反应率显著高于听力阈值对称的患者（48.8%对4.8%；p<0.01）。治愈率与症状持续时间显著相关。单侧耳鸣和听力不对称与听力测定反应率呈正相关。
症状持续时间影响ITD治疗急性主观性耳鸣的治愈率。单侧耳鸣比双侧耳鸣症状改善更好。此外，单侧耳鸣和听力不对称与听力测定反应呈正相关。
