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[鼓室内注射地塞米松与耳后骨膜下注射甲泼尼龙治疗突发性听力损失]

[Intratympanic dexamethasone vesus post-auricular subperiosteal injection of methylprednisolone treatment for sudden hearing loss].

作者信息

Li D B, Zhou S, Xu W J

机构信息

Department of Otolaryngology, Meishan People's Hospital, Meishan, 620010, Chin.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Aug 20;31(16):1265-1268. doi: 10.13201/j.issn.1001-1781.2017.16.011.

Abstract

To compare the efficacy and side effect between intratympanic dexamethasone and subperiosteal injection of methylprednisolone treatment for sudden hearing loss.One hundred and eight unilateral sudden hearing loss patients were enrolled in this study, randomly divided into A group, which was accepted intratympanic dexamethasone (10 mg/ml) , and B group, which was accepted post-auricular subperiosteal injection of methylprednisolone (40 mg/ml) by every 3 days intotal 5 times. After 3 months follow-up, analysis of the differences of pure tone threshold, tinnitus handicap inventory (THI), dizziness handicap inventory (DHI), blood glucose between pretreatment and postreatment was made. Side effect such as perforation of tympanic membrane, infection of post-auricular skin was also observed.①Both in A and B group, there was no statistical changes in total efficiency and pure tone threshold decrease (> 0.05), whereas the pure tone threshold statistical change was observed in the low frequency sudden deafness between A and B group (< 0.05). ②Both in A and B group, there was no statistical changes in THI (> 0.05), whereas the THI statistical decrease was observed in the high frequency sudden deafness between A and B group (< 0.05). ③There was no statistical change in THI both in A and B group (> 0.05). ④Both in A and B group, there was no statistical changes in fasting plasma glucose between pretreatment and postreatment (> 0.05). ⑤There was no patient who had gotten tympanitis or postauricular infection, although in A group, there were 2 patients had gotten perforation of tympanic membrane, but they all healed after the follow-up.Both topical injection of glucocorticoid can improve pure tone threshold and reduce the score of THI and DHI for sudden hearing loss patients. Intratympanic dexamethasone can reduce more score of THI for high frequency sudden deafness patients whereas subperiosteal injection of methylprednisolone can improve pure tone threshold more for low frequency sudden deafness patients. None of the two administrations elevate blood glucose, but intratympanic dexamethasone have the risk of perforation of tympanic membrane.

摘要

比较鼓室内注射地塞米松与骨膜下注射甲泼尼龙治疗突发性聋的疗效及副作用。本研究纳入108例单侧突发性聋患者,随机分为A组(接受鼓室内注射地塞米松(10mg/ml))和B组(接受耳后骨膜下注射甲泼尼龙(40mg/ml),每3天1次,共5次)。随访3个月后,分析治疗前后纯音听阈、耳鸣 handicap 量表(THI)、眩晕 handicap 量表(DHI)、血糖的差异。同时观察鼓膜穿孔、耳后皮肤感染等副作用。①A组和B组总有效率及纯音听阈下降均无统计学差异(>0.05),而A组和B组低频突发性聋患者纯音听阈有统计学差异(<0.05)。②A组和B组THI均无统计学差异(>0.05),而A组和B组高频突发性聋患者THI有统计学下降(<0.05)。③A组和B组THI均无统计学差异(>0.05)。④A组和B组治疗前后空腹血糖均无统计学差异(>0.05)。⑤虽A组有2例患者发生鼓膜穿孔,但随访后均愈合,两组均无患者发生中耳炎或耳后感染。两种糖皮质激素局部注射均可改善突发性聋患者的纯音听阈,降低THI和DHI评分。鼓室内注射地塞米松对高频突发性聋患者THI评分降低更多,而骨膜下注射甲泼尼龙对低频突发性聋患者纯音听阈改善更明显。两种给药方式均不升高血糖,但鼓室内注射地塞米松有鼓膜穿孔风险。

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