Liu Yangyun, Zhang Caixia, Cao Hang, Jiang Wen, Yang Hui, Li Zhengxian, Chen Qiong, Chang Enge, Fan Tao, Hu Rong, Zhou En
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Apr;29(8):719-22.
To explore the best time of intratympanic dexamethasone injection to treat sudden sensorineural hearing loss (SSNHL) as salvage therapy so that to improve the curative efficacy on sudden deafness at the utmost.
A total of 192 patients with SSNHL were included in this study, among whom 63 cases received the systemic steroid therapy throughout the study, while the other ones were treated with systemic steroid as initial treatment and were given intratympanic steroid administration as salvage treatment starting at different time point. The salvage treatment started on the 3rd day after the beginning of the initial treatment for 29 cases, on the 7th day for 38 cases, on the 14th day for 43 cases, and 1 month later for 19 cases. All the patients were followed up for 2 months.
The recovery rates and total effective rates showed no statistically significant difference between the patients received only systemic steroid therapy and the ones received intratympanic steroid administration on the 3rd, 7th day and 1 month later after the initial treatment. The recovery rate and total effective rate exhibited statistically significant difference between the patients received intratympanic steroid administration since the 14th day after the initial treatment and the ones received only systemic steroid therapy, with the numerical value of P 0. 037 and 0. 034, respectively.
(1) As an initial management plan, the curative effects. between the intratympanic steroid administration and the systemic steroid therapy were not significantly different. (2) As a salvage treatment, intratympanic steroid was a better choice for patients who have not completely recover from ISSNHL after failure of initial management with systemic steroid only. (3) The best time point of salvage treatment with intratympanic steroid was about 2 weeks after initial management with systemic steroid.
探讨鼓室内注射地塞米松作为挽救治疗突发性感音神经性听力损失(SSNHL)的最佳时机,以最大限度提高突发性聋的疗效。
本研究共纳入192例SSNHL患者,其中63例在整个研究过程中接受全身类固醇治疗,其余患者以全身类固醇作为初始治疗,并在不同时间点开始鼓室内给予类固醇作为挽救治疗。29例在初始治疗开始后第3天开始挽救治疗,38例在第7天开始,43例在第14天开始,19例在1个月后开始。所有患者随访2个月。
仅接受全身类固醇治疗的患者与初始治疗后第3天、第7天和1个月后接受鼓室内类固醇注射的患者的恢复率和总有效率在统计学上无显著差异。初始治疗后第14天开始接受鼓室内类固醇注射的患者与仅接受全身类固醇治疗的患者的恢复率和总有效率在统计学上有显著差异,P值分别为0.037和0.034。
(1)作为初始治疗方案,鼓室内注射类固醇与全身类固醇治疗的疗效无显著差异。(2)作为挽救治疗,对于仅接受全身类固醇初始治疗失败后未完全恢复的ISSNHL患者,鼓室内注射类固醇是更好的选择。(3)鼓室内类固醇挽救治疗的最佳时间点是在全身类固醇初始治疗后约2周。