Emami Hamed, Tajdini Ardavan, Amirzargar Behrooz, Habibi Saleh, Varpaei Hesam Aldin, Gholami Reza, Karimi Ahang, Jazini Zadeh Saber, Mehrban Amir Hosein
Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, North Sa'adi Ave, Enghelab Blv, Tehran, Iran.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3545-3552. doi: 10.1007/s12070-023-04032-5. Epub 2023 Jul 4.
Sudden sensorineural hearing loss (SSNHL) is a condition in which a person experiences a rapid loss of hearing, often in one ear. The cause of SSNHL is not always clear, but it is thought to be related to issues with the inner ear, auditory nerve, or other parts of the hearing pathway. Intratympanic injection is a treatment method for SSNHL in which a medication (corticosteroids) is injected directly into the middle ear space through the tympanic membrane. This randomized clinical trial was conducted in two hospitals in Tehran, Iran. Patients with SSNHL were randomized (using the 4-block method) and included in this study. 0.5 cc of dexamethasone or triamcinolone was injected via a 25-gauge spinal needle into the cone of light of tympanic membrane. This procedure was repeated six times. In the present study, the rate of response to treatment was compared in the two groups of triamcinolone and dexamethasone, which showed that in the group where intratympanic injection of dexamethasone was performed, 70.9% of patients responded to treatment (48.4% had a complete response and 22.5% had a partial response), and in the group receiving intratympanic triamcinolone, 72.5% responded to the treatment and improved, 50% showed a complete response and 22.5% showed a partial response, and no significant difference was found in the statistical analysis of the two groups. Also, the comparison of audiometric parameters (SDS and SRT) did not show any significant difference before and after the treatment based on the treatment group, and the treatment response was found in the same group. No significant differences were noted in terms of outcome. Intratympanic dexamethasone injection was associated with a 70.9% response and triamcinolone injection with a 72.5% response.
突发性感音神经性听力损失（SSNHL）是一种人们会突然出现听力丧失的病症，通常累及单耳。SSNHL的病因并不总是明确，但据认为与内耳、听神经或听力传导通路的其他部分的问题有关。鼓室内注射是一种针对SSNHL的治疗方法，即通过鼓膜将一种药物（皮质类固醇）直接注射到中耳腔。这项随机临床试验在伊朗德黑兰的两家医院进行。患有SSNHL的患者被随机分组（采用4组区组法）并纳入本研究。通过25号脊椎穿刺针将0.5毫升地塞米松或曲安奈德注射到鼓膜的光锥处。该操作重复六次。在本研究中，比较了曲安奈德和地塞米松两组的治疗反应率，结果显示，在进行鼓室内注射地塞米松的组中，70.9%的患者对治疗有反应（48.4%完全缓解，22.5%部分缓解），在接受鼓室内注射曲安奈德的组中，72.5%的患者对治疗有反应并有所改善，50%完全缓解，22.5%部分缓解，两组的统计分析未发现显著差异。此外，基于治疗组的听力测定参数（SDS和SRT）在治疗前后的比较也未显示任何显著差异，且在同一组中发现了治疗反应。在结果方面未发现显著差异。鼓室内注射地塞米松的反应率为70.9%，注射曲安奈德的反应率为72.5%。
