Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Otol Neurotol. 2019 Oct;40(9):1134-1138. doi: 10.1097/MAO.0000000000002386.
Intratympanic (IT) steroid administration for sudden sensorineural hearing loss is offered as salvage to patients who failed systemic steroid treatment. Our objective was to study the audiometric and clinical outcomes of patients given salvage therapy with high-dose IT steroids instilled via ventilation tube.
Retrospective case review.
Academic secondary medical center.
One hundred three patients >18 years of age with sudden sensorineural hearing loss who failed systemic steroids and received IT treatment between 2010 and 2018.
Following ventilation tube insertion, 1 ml of 10 mg/ml dexamethasone was instilled, twice daily, for 7 days.
Hearing assessment immediately before and after treatment. Tinnitus and vertigo complaints and risk factors were also retrieved.
Tinnitus had improved in 53 (52%) patients, vertigo in 4 (4%), and aural fullness sensation in 56 (55%) (p < 0.001, p = 0.344, p < 0.001, respectively). The mean pure-tone threshold difference across frequencies following treatment was between 0 and 6 dB. A significant improvement was observed at 250, 500, 1000 Hz (p < 0.001 in all), and at 2000 Hz (p = 0.035). No significant difference was found at 4000 and 8000 Hz (p = 0.055, p = 0.983 respectively). Mean pure-tone average improvement of 4.5 dB was detected in 61 (59%) patients (p = 0.001). The mean speech discrimination score improved by 7% (p = 0.001). Four (22%) diabetic and nine (20%) hypertensive patients had pure-tone average ≥10 dB improvement (p = 0.759, p = 0.852 respectively).
Although more than half of the patients improved clinically, the significance of the slight audiometric improvement should be weighed against the treatment protocol's complications.
鼓室内（IT）类固醇给药是对全身类固醇治疗失败的突发性聋患者的一种挽救治疗方法。我们的目的是研究通过通气管给予高剂量 IT 类固醇进行挽救治疗的患者的听力和临床结果。
回顾性病例研究。
学术二级医疗中心。
103 名年龄大于 18 岁的突发性聋患者，他们在 2010 年至 2018 年间接受了全身类固醇治疗失败并接受了 IT 治疗。
在插入通气管后，每天两次各 1 毫升 10mg/ml 地塞米松，共 7 天。
治疗前后听力评估。还检索了耳鸣和眩晕的投诉和危险因素。
53 名（52%）患者的耳鸣改善，4 名（4%）患者的眩晕改善，56 名（55%）患者的耳闷感改善（p<0.001，p=0.344，p<0.001，分别）。治疗后各频率间纯音阈值差异均值在 0 至 6dB 之间。在 250、500、1000Hz（均 p<0.001）和 2000Hz（p=0.035）观察到显著改善。在 4000 和 8000Hz 未发现显著差异（p=0.055，p=0.983）。61 名（59%）患者的纯音平均改善 4.5dB（p=0.001）。言语辨别率平均提高 7%（p=0.001）。4 名（22%）糖尿病患者和 9 名（20%）高血压患者的纯音平均改善≥10dB（p=0.759，p=0.852）。
尽管超过一半的患者在临床上有所改善，但应权衡治疗方案的并发症与轻微听力改善的意义。
