Suzuki Hideaki, Wakasugi Tetsuro, Kitamura Takuro, Koizumi Hiroki, Do Ba Hung, Ohbuchi Toyoaki
1 Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
2 Department of Otorhinolaryngology, Hanoi Medical University, Hanoi, Vietnam.
Ann Otol Rhinol Laryngol. 2018 Apr;127(4):235-240. doi: 10.1177/0003489418755406. Epub 2018 Feb 7.
We studied the effect of intratympanic steroid administration with different total injection times on hearing outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).
The subjects were 191 consecutive patients (192 ears) with ISSNHL (hearing level ≥40 dB, interval between onset and treatment ≤30 days). They received systemic prednisolone (100 mg followed by tapered doses) combined with intratympanic injection of dexamethasone (4 mg/ml). Intratympanic injection was performed 4 times (days 1, 2, 4, and 7) in 92 patients (92 ears) or 2 times (days 1 and 2) in 99 patients (100 ears). The hearing outcomes were evaluated at 1 week from the start of treatment and 1 to 2 months after the completion of treatment.
There was no significant difference in hearing outcomes between the 4- and 2-injection groups at either time point. Multiple regression analysis also showed that the hearing level after treatment did not depend on the total number of intratympanic steroid injections.
These results indicate that a protocol using only 2 intratympanic steroid injections exerts a sufficient effect on the hearing outcomes of ISSNHL. This simplified treatment protocol would be greatly beneficial to relieve the physical and mental stress of patients.
我们研究了不同总注射次数的鼓室内注射类固醇对特发性突发性感音神经性听力损失（ISSNHL）患者听力结果的影响。
研究对象为191例连续的ISSNHL患者（192耳）（听力水平≥40dB，发病与治疗间隔≤30天）。他们接受全身泼尼松龙（100mg，随后逐渐减量）联合鼓室内注射地塞米松（4mg/ml）。92例患者（92耳）进行4次鼓室内注射（第1、2、4和7天），99例患者（100耳）进行2次鼓室内注射（第1和2天）。在治疗开始后1周以及治疗完成后1至2个月评估听力结果。
在两个时间点，4次注射组和2次注射组的听力结果均无显著差异。多元回归分析还显示，治疗后的听力水平不取决于鼓室内类固醇注射的总次数。
这些结果表明，仅使用2次鼓室内类固醇注射的方案对ISSNHL的听力结果具有足够的效果。这种简化的治疗方案将极大地有助于减轻患者的身心压力。
