Rogha Mehrdad, Kalkoo Amin
Department of Otorhinolaryngology, Isfahan University of Medical Science, Isfahan. Iran.
Iran J Otorhinolaryngol. 2017 Sep;29(94):255-260.
Hearing loss is fairly a common disorder which is usually treated with corticosteroids via systemic administration and/or intra-tympanic injection. This study aimed to compare the effectiveness of intra-tympanic injections of dexamethasone with its combination with hyaluronic acid in patients with sudden sensorineural hearing loss.
In this clinical trial, 40 patients were randomly assigned to two groups; in the first group, 20 patients received 2.4 mg intra-tympanic dexamethasone, while in the second group patients received injections of 2.4 mg of dexamethasone plus 2 mg of hyaluronic acid in combination. Patients in both groups were injected every other day to a total of three injections. The hearing status of patients was evaluated by pure tone audiometry (bone conduction threshold) before and 2 weeks after the intervention.
Assessment of hearing threshold before and after treatment in the two groups showed a significant difference between hearing thresholds at frequencies of 4,000 to 8,000 Hz (P<0.001). The difference at other frequencies was not meaningful; however, in general, we found a better therapeutic effect in patients who received the combination of dexamethasone and hyaluronic acid.
A combination of dexamethasone and hyaluronic acid in patients with sudden sensorineural hearing loss may be more effective than dexamethasone alone. Because hyaluronic acid lacks certain side effects, and also makes it possible to reduce the steroid dose, we recommend the use of this combination in the treatment of patients with sudden sensorineural hearing loss.
听力损失是一种相当常见的疾病,通常通过全身给药和/或鼓室内注射皮质类固醇进行治疗。本研究旨在比较鼓室内注射地塞米松及其与透明质酸联合使用对突发性感音神经性听力损失患者的疗效。
在这项临床试验中,40名患者被随机分为两组;第一组,20名患者接受2.4毫克鼓室内地塞米松注射,而第二组患者接受2.4毫克地塞米松加2毫克透明质酸的联合注射。两组患者均每隔一天注射一次,共注射三次。在干预前和干预后2周通过纯音听力测定法(骨导阈值)评估患者的听力状况。
两组治疗前后听力阈值评估显示,4000至8000赫兹频率的听力阈值存在显著差异(P<0.001)。其他频率的差异无意义;然而,总体而言,我们发现接受地塞米松和透明质酸联合治疗的患者具有更好的治疗效果。
地塞米松和透明质酸联合使用对突发性感音神经性听力损失患者可能比单独使用地塞米松更有效。由于透明质酸没有某些副作用,并且还可以降低类固醇剂量,我们建议在治疗突发性感音神经性听力损失患者时使用这种联合疗法。