Department of Otolaryngology, the First Affiliated Hospital of Huzhou University, the First People's Hospital of Huzhou, Huzhou, 313000, Zhejiang, China.
Ir J Med Sci. 2021 Aug;190(3):1165-1172. doi: 10.1007/s11845-021-02610-6. Epub 2021 Apr 17.
Postauricular steroid administration has been popular for treating sudden sensorineural hearing loss. However, there are few reports on its use in patients with refractory sudden sensorineural hearing loss (RSSNHL).
The objective of this study was to investigate the therapeutic efficacy of postauricular steroid injection as a salvage treatment for RSSNHL patients.
This retrospective study enrolled 63 RSSNHL patients between January 2016 and January 2019. Thirty-three patients of them who have been divided into the treatment group received postauricular methylprednisolone sodium succinate injection. The remaining 30 patients who formed the control group did not receive any steroid as a salvage therapy. Improvements in hearing were evaluated between pre-salvage therapy and 3 months follow-up after salvage therapy.
The median hearing gain in PTA was 9.88 dB HL (quartile range 7.58, 18.65) in the treatment group and 0.90 dB HL (quartile range 0.00, 4.90) in the control group (P<0.01). According to the criteria of Furuhashi, the total percentage for effective prognosis was 48.48% (16/33) in the treatment group and 10.00% (3/30) in the control group (P<0.01). The time interval from onset to study entry was significantly and independently associated with the prognosis for RSSNHL patients (P< 0.01).
The present findings suggest that postauricular corticosteroid administration as a salvage treatment demonstrated better results than no treatment for RSSNHL patients. The time interval from onset to study entry was mainly the prognostic factor for RSSNHL patients. It is therefore considered that postauricular corticosteroid administration may be used as a salvage therapy for RSSNHL patients.
耳后类固醇给药已广泛用于治疗突发性聋，但很少有关于其在难治性突发性聋（RSSNHL）患者中的应用报道。
本研究旨在探讨耳后类固醇注射作为 RSSNHL 患者挽救性治疗的疗效。
本回顾性研究纳入了 2016 年 1 月至 2019 年 1 月期间的 63 例 RSSNHL 患者。其中 33 例患者被分为治疗组，接受耳后甲泼尼龙琥珀酸钠注射治疗。其余 30 例患者作为对照组，未接受任何类固醇作为挽救性治疗。在挽救性治疗前和挽救性治疗后 3 个月评估听力改善情况。
治疗组患者的平均听阈提高值为 9.88dBHL（四分位间距 7.58，18.65），对照组为 0.90dBHL（四分位间距 0.00，4.90）（P<0.01）。根据 Furuhashi 的标准，治疗组有效预后的总百分比为 48.48%（16/33），对照组为 10.00%（3/30）（P<0.01）。发病至入组的时间间隔与 RSSNHL 患者的预后显著相关（P<0.01）。
本研究结果表明，与不治疗相比，耳后皮质类固醇给药作为挽救性治疗对 RSSNHL 患者更有效。发病至入组的时间间隔是 RSSNHL 患者的主要预后因素。因此，耳后皮质类固醇给药可作为 RSSNHL 患者的挽救性治疗。
