Department of Otorhinolaryngology-Head and Neck Surgery, 12387Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China.
Ear Nose Throat J. 2021 Jun;100(3_suppl):309S-316S. doi: 10.1177/0145561320904816. Epub 2020 Feb 19.
Sudden sensorineural hearing loss is a common otologic disease in clinic. Systemic and intratympanic steroid treatment have been proved to be effective, but the regimens vary from center to center. The purpose of the study is to analyze the effects of the combined application of intravenous dexamethasone and intratympanic methylprednisolone injection in different time strategies for the treatment of unilateral sudden sensorineural hearing loss. A retrospective chart review was performed for the period from March 2016 to June 2018 at our Department of Otorhinolaryngology-Head and Neck Surgery. A total number of 61 patients who met the academy criteria for unilateral sudden hearing loss were included and grouped based on the time to introduce intratympanic methylprednisolone. All the patients received intravenous dexamethasone 10 mg once daily for 5 days, followed 5 mg once daily for the next 7 days. Intratympanic methylprednisolone (40 mg) was injected every other day 4 times into all patients. This regimen was commenced on day 1 in group 1 and on day 6 in group 2. The pre and posttreatment pure-tone audiograms were analyzed. Sixty-one patients met our inclusion criteria. No significant differences were observed between patients' demographics or pretreatment hearing thresholds. In the 3 months posttreatment pure-tone audiogram assessment, the mean hearing threshold improvement were similar between groups with no frequency specificity. The curative rate in both groups were similar and satisfying. Two patients with diabetes mellitus had persistent small perforations. Some patients had other transient discomfort that disappeared before discharge. The different timing of initiation of intratympanic methylprednisolone injection does not significantly affect the outcome of the treatment for sudden sensorineural hearing loss. Thus, we suggest that intratympanic steroid injection should not be applied as a first-line method except for patients who do not respond early to systemic steroid therapy.
突发性聋是临床常见的耳科疾病，系统应用和鼓室内应用类固醇治疗已被证实有效，但方案因中心而异。本研究旨在分析不同时间点应用静脉注射地塞米松联合鼓室内注射甲泼尼龙治疗单侧突发性聋的疗效。回顾性分析 2016 年 3 月至 2018 年 6 月在我院耳鼻咽喉头颈外科就诊的单侧突发性聋患者 61 例，根据鼓室内注射甲泼尼龙的时间分组。所有患者均给予静脉注射地塞米松 10 mg/d，连续 5 天，第 6~11 天改为 5 mg/d，同时给予所有患者鼓室内注射甲泼尼龙（40 mg），隔日 1 次，共 4 次，第 1 天开始注射（A 组）和第 6 天开始注射（B 组）。分析治疗前后纯音测听结果。61 例患者符合纳入标准，患者的人口统计学资料和治疗前听力阈值无差异。治疗后 3 个月纯音测听评估，两组间平均听力阈值改善无差异，也无频率特异性。两组间的有效率相似且满意。2 例糖尿病患者鼓膜小穿孔持续存在，部分患者出现其他短暂不适，出院前消失。鼓室内注射甲泼尼龙的不同起始时间并不显著影响突发性聋的治疗效果。因此，我们建议除对全身激素治疗反应不佳的患者外，鼓室内激素注射不应作为一线治疗方法。
