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鼓膜切开置管联合地塞米松滴耳与鼓室内注射激素治疗突发性聋的随机前瞻性临床试验。

Dexamethasone eardrop with grommet placement vs intratympanic steroid injection for sudden sensorineural hearing loss: A randomized prospective clinical trial.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong.

School of Public Health, The Chinese University of Hong Kong, Hong Kong.

出版信息

Am J Otolaryngol. 2020 Jul-Aug;41(4):102515. doi: 10.1016/j.amjoto.2020.102515. Epub 2020 Apr 26.

Abstract

OBJECTIVES

The purpose of this study was to compare different means of intratympanic steroid delivery in the treatment of idiopathic sudden sensorineural hearing loss.

DESIGN

Prospective, multicentered, randomized controlled trial.

SETTING AND PARTICIPANTS

Fifty-six patients who fulfilled the inclusion criteria for idiopathic sudden sensorineural hearing loss who failed or were contraindicated for oral steroids were included in this study. Patients were randomly divided into 2 groups according to delivery methods: group A received 4 sections of intratympanic dexamethasone injection and group B received grommet placement with dexamethasone delivery followed by 3 sections of dexamethasone ear drop application. Self-administered paper-based questionnaires were filled out to measure subjective pain scores, vertigo, anxiety, and overall satisfaction immediately after each procedure. Hearing threshold was measured with pure tone audiogram in the follow-up.

RESULTS

There was no statistical significance detected in hearing threshold improvement between both groups (P = 0.30). Grommet placement followed by dexamethasone eardrop application demonstrated a significant difference in shorter waiting time (24 min in grommet group vs 52 min in injection group; P < 0.01); and better overall satisfaction (1.6 in grommet group vs 2.5 in injection group; P < 0.05).

CONCLUSIONS

Grommet placement followed by dexamethasone eardrop application is a good alternative for a patient indicated for intratympanic steroid, with less administrative cost, shorter waiting time, and more satisfaction.

摘要

目的

本研究旨在比较鼓室内类固醇给药的不同方法在治疗特发性突发性聋中的效果。

设计

前瞻性、多中心、随机对照试验。

地点和参与者

本研究纳入了 56 名符合特发性突发性聋纳入标准且对口服类固醇治疗无效或禁忌的患者。根据给药方法,患者随机分为 2 组:A 组接受 4 次鼓室内地塞米松注射,B 组接受鼓膜置管加地塞米松给药,随后进行 3 次地塞米松滴耳。患者在每次治疗后立即通过自我管理的纸质问卷评估主观疼痛评分、眩晕、焦虑和总体满意度。在随访中通过纯音测听测量听力阈值。

结果

两组间听力阈值改善无统计学差异(P=0.30)。鼓膜置管加地塞米松滴耳的等待时间更短(鼓膜组 24 分钟,注射组 52 分钟;P<0.01),总体满意度更高(鼓膜组 1.6 分,注射组 2.5 分;P<0.05)。

结论

对于需要鼓室内类固醇治疗的患者,鼓膜置管加地塞米松滴耳是一种较好的替代方法,具有较低的管理成本、更短的等待时间和更高的满意度。

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