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鼓室内注射地塞米松时添加利多卡因治疗耳鸣的疗效评估:一项前瞻性、随机、对照双盲试验

Evaluation of Adding Lidocaine to Dexamethasone in the Intra-tympanic Injection for Management of Tinnitus: A Prospective, Randomized, Controlled Double-blinded Trial.

作者信息

Elzayat Saad, Ragab Sameh, Eisa Magdy, Amer Mohamed, Mandour Mahmoud F, Mehraz Mai

机构信息

Department of Otorhinolaryngology, Kaferelsheikh University, Egypt.

Department of Otorhinolaryngology, Tanta university, Egypt.

出版信息

Int Tinnitus J. 2018 Jun 1;22(1):54-59. doi: 10.5935/0946-5448.20180009.

Abstract

OBJECTIVES

Assessment of adding lidocaine to dexamethasone in the intratympanic injections for the treatment of subjective idiopathic tinnitus (SIT).

METHOD

A prospective, controlled, randomized, double-blind study of forty-four patients with SIT diagnosed in the Department of Otolaryngology, Tanta University Hospital, a tertiary academic medical centre from March 2015 to October 2016. 44 patients were recruited in the study and were categorized into two groups; (A) included 22 patients managed with ITLD, and (B) included 22 patients managed with intratympanic postoperative ITD injection. Intratympanic injections were double-blind performed three times with one weak interval. After three and six months, the tinnitus improvement was studied using the following parameters: Arabic tinnitus questionnaires (ATQ), loudness matching test and Tinnitus handicap index (THI).

RESULTS

The effectiveness rates of ITLD for idiopathic tinnitus reported in the ATQ, THI, and in the loudness matching test were 74.5% in the ITDL group and 50.0%, 50.5%, and 40.0% in the ITD group, respectively. Statistically, there was a significant difference between both groups in 6 months duration.

CONCLUSION

ITLD seems to be effective for SIT than ITD alone. The indication of ITLD for tinnitus needs to be limited to specific cases of resistant medical treatment.

摘要

目的

评估在鼓室内注射地塞米松时添加利多卡因用于治疗主观性特发性耳鸣(SIT)的效果。

方法

一项前瞻性、对照、随机、双盲研究,研究对象为2015年3月至2016年10月在三级学术医学中心坦塔大学医院耳鼻喉科诊断为SIT的44例患者。44例患者被纳入研究并分为两组;(A)组包括22例接受鼓室内利多卡因联合地塞米松注射(ITLD)治疗的患者,(B)组包括22例接受鼓室内注射地塞米松(ITD)治疗的患者。鼓室内注射采用双盲法,每隔一周进行一次,共进行三次。在三个月和六个月后,使用以下参数研究耳鸣改善情况:阿拉伯语耳鸣问卷(ATQ)、响度匹配测试和耳鸣障碍指数(THI)。

结果

在ATQ、THI和响度匹配测试中,ITLD治疗特发性耳鸣的有效率在ITDL组为74.5%,在ITD组分别为50.0%、50.5%和40.0%。统计学上,两组在六个月时存在显著差异。

结论

ITLD似乎比单独使用ITD治疗SIT更有效。ITLD治疗耳鸣的适应症应限于特定的药物治疗抵抗病例。

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