鼓室内注射类固醇作为突发性感音神经性听力损失的挽救治疗方法。
Intratympanic steroid injection as a salvage treatment for sudden sensorineural hearing loss.
作者信息
Belhassen S, Saliba I
机构信息
Division of Otolaryngology-Head and Neck Surgery,University of Montreal,Quebec,Canada.
Montreal University Hospital Centre (CHUM),Quebec,Canada.
出版信息
J Laryngol Otol. 2014 Dec;128(12):1044-9. doi: 10.1017/S0022215114002710. Epub 2014 Nov 17.
OBJECTIVE
To determine the efficacy of intratympanic methylprednisolone injections for treating sudden sensorineural hearing loss.
METHOD
A retrospective chart review was performed to identify patients suffering from sudden sensorineural hearing loss with no recovery after oral steroids. Patients were given up to three intratympanic methylprednisolone injections at one-week intervals. They were classified according to their functional hearing class, remission was monitored and potential factors affecting prognosis were analysed.
RESULTS
Intratympanic injections provide effective salvage therapy for sudden sensorineural hearing loss (p = 0.039). Changes in pure tone average and speech discrimination score were analysed following intratympanic methylprednisolone injections. The pure tone average reached a plateau after the second injection; however, the speech discrimination score improved until after the third injection. Hearing improvement after intratympanic injections mainly occurred at low frequencies. The interval between symptoms appearing and intratympanic injections starting was not significantly associated with remission (p = 0.680).
CONCLUSION
A delay between symptom onset and the first intratympanic methylprednisolone injection does not seem to affect prognosis.
目的
确定鼓室内注射甲泼尼龙治疗突发性感音神经性听力损失的疗效。
方法
进行一项回顾性病历审查，以确定口服类固醇治疗后未恢复的突发性感音神经性听力损失患者。患者每隔一周接受最多三次鼓室内甲泼尼龙注射。根据其功能性听力分级进行分类，监测缓解情况并分析影响预后的潜在因素。
结果
鼓室内注射为突发性感音神经性听力损失提供了有效的挽救治疗（p = 0.039）。分析了鼓室内注射甲泼尼龙后纯音平均听阈和言语识别得分的变化。第二次注射后纯音平均听阈达到平稳状态；然而，言语识别得分在第三次注射后才有所改善。鼓室内注射后的听力改善主要发生在低频。症状出现与开始鼓室内注射之间的间隔与缓解无显著相关性（p = 0.680）。
结论
症状发作与首次鼓室内注射甲泼尼龙之间的延迟似乎不影响预后。
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