He Haixia, Yuan Kun, Chen Wei, Zhang Qiong, Han Yiming, Weng Jing, Pan Hong
Department of Otorhinolaryngology Head and Neck Surgery，the Central Hospital of Wuhan，Tongji Medical College，Huazhong University of Science and Technology，Wuhan，430014，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Feb;34(2):124-127. doi: 10.13201/j.issn.1001-1781.2020.02.006.
The aim of this study is to explore the best administration, timing and efficacy of dexamethasone and Mison in the treatment of different types of sudden deafness. 242 cases of sudden deafness first diagnosed in our department were selected. According to the guidelines（2015）, the patients were divided into low frequency descending type （49 cases）, high frequency descending type （66 cases）, flat descending type （71 cases） and total deafness （56 cases）. Different types of patients were randomly divided into tympanic injection group and systemic administration group on the basis of routine treatment. Tympanic injection group was further divided into initial injection group and delayed injection group. Tympanic injection was performed under ear endoscope, once every other day, three times for low frequency descending deafness, and five times for other types of deafness. In comparison of total effective rate, there were significant differences among the three treatments in 49 cases of low frequency descending type, 71 cases of flat descending type and 56 cases of total deafness type （<0.05）. In 66 cases of high frequency descending type, there was no significant difference among the three treatments （>0.05）. In the comparison of cure rate, the difference of cure rate among the three treatment methods was also significant in low frequency descending type （<0.05）. In the other three types of deafness, there was no significant difference among the three treatment methods （>0.05）. There was no significant difference in the effective rate between men and women （>0.05） in all patients treated by tympanic injection. There was significant difference in the effective rate of tympanic injection within 7 days of onset and 7 days after onset （<0.05）. Intratympanic injection of dexamethasone is safe, effective, and easy to use as an initial treatment for low frequency descent, flat, and full deafness, and the sooner the better.
本研究旨在探讨地塞米松和米索前列醇治疗不同类型突发性聋的最佳给药方式、时机及疗效。选取在我科首次确诊的242例突发性聋患者。根据《指南（2015）》，将患者分为低频下降型（49例）、高频下降型（66例）、平坦下降型（71例）和全聋型（56例）。不同类型患者在常规治疗基础上随机分为鼓室注射组和全身给药组。鼓室注射组再分为早期注射组和延迟注射组。在耳内镜下进行鼓室注射，隔日1次，低频下降型耳聋注射3次，其他类型耳聋注射5次。在49例低频下降型、71例平坦下降型和56例全聋型患者中，三种治疗方法的总有效率比较差异有统计学意义（<0.05）。在66例高频下降型患者中，三种治疗方法差异无统计学意义（>0.05）。在治愈率比较中，低频下降型三种治疗方法的治愈率差异也有统计学意义（<0.05）。在其他三种类型耳聋中，三种治疗方法差异无统计学意义（>0.05）。鼓室注射治疗的所有患者中，男女有效率差异无统计学意义（>0.05）。发病7天内与发病7天后鼓室注射的有效率差异有统计学意义（<0.05）。鼓室内注射地塞米松作为低频下降型、平坦型和全聋型耳聋的初始治疗安全、有效且使用方便，越早越好。
