Department of Otorhinolaryngology-Head and Neck Surgery, Eulji University School of Medicine, Nowon Eulji Medical Center, Seoul, Korea.
J Int Adv Otol. 2020 Dec;16(3):338-345. doi: 10.5152/iao.2020.8205.
The purpose of this study was to determine the factors predicting the success or failure of intratympanic dexamethasone (ITD) injection in the treatment of acute subjective tinnitus (AST).
We enrolled patients who were treated with ITD within 3 months of the onset of tinnitus, between 2013 and 2017. We compared the clinical characteristics and audiological data of the patients in the cured group (n=38, 45.6±13.3 years old) and the nonresponder group (n=40, 48.9±18.6 years old).
The cured group was predominantly female (p=0.002). The mean duration of tinnitus before ITD was shorter in the cured group than the nonresponder group (p=0.002). The pure-tone averages in both sides were lower in the cured group than in the nonresponder group (p=0.018). The time of tinnitus awareness was shorter in the cured group than in the nonresponder group (p=0.014). Multivariable analysis showed that the duration of tinnitus (odds ratio [OR]=1.045), a history of exposure to noise just before tinnitus development (OR=7.766), and distortion product otoacoustic emissions results (OR=4.580) predicted the outcome of ITD treatment in AST.
A short duration of tinnitus, no history of immediate noise exposure, and normal distortion product otoacoustic emissions could be favorable prognostic factors for AST treated with ITD injection.
本研究旨在确定预测鼓室内注射地塞米松（ITD）治疗急性主观性耳鸣（AST）成功或失败的因素。
我们招募了在耳鸣发作后 3 个月内接受 ITD 治疗的患者，研究时间为 2013 年至 2017 年。我们比较了治愈组（n=38，45.6±13.3 岁）和无反应组（n=40，48.9±18.6 岁）患者的临床特征和听力数据。
治愈组女性居多（p=0.002）。与无反应组相比，治愈组 ITD 治疗前耳鸣持续时间较短（p=0.002）。治愈组双耳纯音平均值低于无反应组（p=0.018）。治愈组的耳鸣感知时间短于无反应组（p=0.014）。多变量分析显示，耳鸣持续时间（比值比 [OR]=1.045）、耳鸣发作前接触噪声的病史（OR=7.766）和畸变产物耳声发射结果（OR=4.580）预测了 AST 患者 ITD 治疗的结果。
耳鸣持续时间短、无即时噪声暴露史和正常的畸变产物耳声发射可能是 ITD 治疗 AST 的有利预后因素。
