Zhong S X, Zuo W Q, Zhang B Y, Qian Y, Lei Y
Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Nov 7;53(11):806-810. doi: 10.3760/cma.j.issn.1673-0860.2018.11.002.
To investigate the proper time of intratympanic steroid as combination therapy in treatment of patients with profound sudden sensorineural hearing loss(SSNHL) of total frequency type. This prospective study included 50 patients with SSNHL in the First Affiliated Hospital of Chongqing Medical University from June 2017 to February 2018.All these patients had profound hearing loss averaged more than 81 dB at all frequencies (250-8 000 Hz). They were divided into two groups.The patients in group A were treated with simultaneous oral prednisone (1 mg/kg, qd) and intratympanic methylprednisolone (40 mg, qd) for 5 days.The patients in group B were treated with oral prednisone for 5 days as in group A, and then those who had no significant improvement were subsequently treated with intratympanic methylprednisolone (40 mg, qd)for further 5 days.All patients were treated with additional intravenous batroxobin and ginkgo biloba leaves extract.Following examination of pure tone audiogram, hearing gains and effective rates were statistically analyzed in both groups with SPSS software package(version 20.0). Hearings in both groups were improved significantly after treatment.In group A(20 cases), hearing gain was (29.2±22.7) dB and total effective rate was 65.0%, while in group B(22 cases), they were (27.3±22) dB and 68.2% respectively.There were no significant differences in hearing gain and recovery rate between two groups (hearing gain, =0.793; total effective rate, =0.827). For patients with profound SSNHL of total frequency type, the efficacies of intratympanic steroid as simultaneous and subsequent therapy are equivalent. Therefore, subsequent intratympanic glucocorticoid is recommended for SSNHL patient of total frequency type to reduce complications and medical expenses.
探讨鼓室内注射类固醇作为联合治疗全频型重度突发性感音神经性听力损失(SSNHL)患者的适宜时机。本前瞻性研究纳入了2017年6月至2018年2月在重庆医科大学附属第一医院就诊的50例SSNHL患者。所有这些患者在所有频率(250 - 8000Hz)的平均听力损失均超过81dB。他们被分为两组。A组患者同时口服泼尼松(1mg/kg,每日1次)和鼓室内注射甲泼尼龙(40mg,每日1次),共治疗5天。B组患者先如A组一样口服泼尼松5天,然后对无明显改善的患者后续再鼓室内注射甲泼尼龙(40mg,每日1次),持续5天。所有患者均额外接受静脉注射巴曲酶和银杏叶提取物治疗。在进行纯音听力图检查后,使用SPSS软件包(版本20.0)对两组的听力增益和有效率进行统计学分析。两组患者治疗后听力均有显著改善。A组(20例)听力增益为(29.2±22.7)dB,总有效率为65.0%;B组(22例)听力增益为(27.3±22)dB,总有效率为68.2%。两组之间的听力增益和恢复率无显著差异(听力增益,P = 0.793;总有效率,P = 0.827)。对于全频型重度SSNHL患者,鼓室内注射类固醇作为同时治疗和后续治疗的疗效相当。因此,对于全频型SSNHL患者,建议采用后续鼓室内注射糖皮质激素的方法,以减少并发症和医疗费用。