Weitgasser Lennart, Tschani Stefan, Kogler Magdalena, Armstorfer Maximilian, Schimetta Wolfgang, Roesch Sebastian
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Salzburg, Muellner Hauptstrasse 48, Salzburg, 5020, Austria.
Department of Clinical Pharmacy and Drug Information, Landesapotheke Salzburg, Salzburg, Austria.
Eur Arch Otorhinolaryngol. 2025 Apr 21. doi: 10.1007/s00405-025-09387-9.
Comparison of dexamethasone phosphate (DXA) and triamcinolone acetonide (TCA) for intratympanic therapy (IT) in patients with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) to reveal a potential superiority regarding the efficiency to improve hearing function.
Retrospective, monocentric, two-armed cohort-study. Analysis of clinical and audiometric data of patients treated with IT for unilateral ISSNHL. 118 adults, who received IT with DXA (n = 67) or TCA (n = 51) were included. Main outcome parameters were hearing improvement in percent and decibel (dB) in relation to the healthy ear within a follow-up period of three months. Response to therapy was defined as an improvement of at least 10dB in affected frequencies.
Median improvement was 24.6% and 6.2 dB in the DXA group, 31.4% and 10.0 dB in the TCA group. For the response analysis, 7 patients dropped out. Of the remaining 111 patients, 27 (43,5%; 95%CI 30,9-56,7) in the DXA and 26 (53,0%; 95%CI 38,2-67,4) in the TCA group showed response. Analysis of the outcome parameters showed no statistically remarkable difference (p < 0,05) between the two cohorts. The difference of initial pure tone average between the affected and healthy ear and the time between symptom onset and first IT, was confirmed as an influencing factor to the outcome.
For intratympanic treatment of ISSNHL dexamethasone phosphate and triamcinolone acetonide seem equivalent considering its ability to improve hearing function. A more severe hearing loss and a short duration between onset and therapy may favor the chance of hearing recovery.
比较地塞米松磷酸钠（DXA）和曲安奈德（TCA）用于单侧特发性突发性感音神经性听力损失（ISSNHL）患者鼓室内注射治疗（IT）时，在改善听力功能效率方面的潜在优势。
回顾性、单中心、双臂队列研究。分析接受IT治疗单侧ISSNHL患者的临床和听力数据。纳入118例接受DXA（n = 67）或TCA（n = 51）鼓室内注射的成年人。主要结局参数为在三个月随访期内患耳相对于健耳听力改善的百分比和分贝（dB）。治疗反应定义为患侧频率至少改善10dB。
DXA组的中位数改善为24.6%和6.2dB，TCA组为31.4%和10.0dB。在反应分析中，7例患者退出。在其余111例患者中，DXA组27例（43.5%；95%CI 30.9 - 56.7），TCA组26例（53.0%；95%CI 38.2 - 67.4）显示有反应。对结局参数的分析显示两组之间无统计学显著差异（p < 0.05）。患耳与健耳之间初始纯音平均差值以及症状发作与首次IT治疗之间的时间被确认为影响结局的因素。
对于ISSNHL的鼓室内治疗，考虑到改善听力功能的能力，地塞米松磷酸钠和曲安奈德似乎等效。更严重的听力损失以及发作与治疗之间的短时间间隔可能有利于听力恢复。
