Dai Y, Lu L, Hou J, Yang X, Li H, Yang Y, She W
Department of Otolaryngology - Head and Neck Surgery,Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University,People's Republic of China.
Department of Otolaryngology - Head and Neck Surgery,Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School,People's Republic of China.
J Laryngol Otol. 2017 May;131(5):404-410. doi: 10.1017/S0022215117000548. Epub 2017 Mar 14.
This study aimed to examine the effectiveness of intratympanic methylprednisolone perfusion as salvage treatment for profound idiopathic sudden sensorineural hearing loss.
A retrospective clinical study of 97 patients with unilateral profound idiopathic sudden sensorineural hearing loss was performed. In all, 83 patients who received salvage intratympanic methylprednisolone perfusion plus conventional treatment (except for steroids) as the second-line therapy were assigned to the study group, while 14 patients who received conventional treatment alone were assigned to the comparison group.
In the study group, treatments in patients with a shorter interval from disease onset to intratympanic methylprednisolone perfusion (up to 15 days) had significantly greater improvements in the overall effective rate and pure tone average compared with patients with a longer interval (over 15 days). For patients with a short interval from disease onset to intratympanic methylprednisolone perfusion, those in the study group had significantly greater improvements in the overall effective rate and pure tone average compared with those in the comparison group. In both the study and comparison groups, hearing improvements were greater at low frequencies than at medium and high frequencies.
The interval from disease onset to intratympanic methylprednisolone perfusion was the major factor affecting hearing recovery. Early second-line salvage intratympanic methylprednisolone perfusion significantly improved the degree of hearing recovery in profound idiopathic sudden sensorineural hearing loss patients after failure of systemic steroid treatment.
本研究旨在探讨鼓室内注射甲泼尼龙灌注作为极重度特发性突发性感音神经性听力损失挽救治疗的有效性。
对97例单侧极重度特发性突发性感音神经性听力损失患者进行回顾性临床研究。总共83例接受鼓室内注射甲泼尼龙灌注加常规治疗(除类固醇外)作为二线治疗的患者被分配到研究组,而14例仅接受常规治疗的患者被分配到对照组。
在研究组中,从发病到鼓室内注射甲泼尼龙灌注间隔时间较短(长达15天)的患者与间隔时间较长(超过15天)的患者相比,总有效率和纯音平均听阈有显著更大的改善。对于从发病到鼓室内注射甲泼尼龙灌注间隔时间短的患者,研究组患者的总有效率和纯音平均听阈与对照组相比有显著更大的改善。在研究组和对照组中,低频听力改善均高于中频和高频。
从发病到鼓室内注射甲泼尼龙灌注的间隔时间是影响听力恢复的主要因素。早期二线挽救性鼓室内注射甲泼尼龙灌注显著提高了系统性类固醇治疗失败后极重度特发性突发性感音神经性听力损失患者的听力恢复程度。