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经饱和明胶海绵鼓室内注射类固醇与鼓室内注射治疗突发性感音神经性听力损失的比较

Intratympanic steroid via saturated gelfoam vs. intratympanic injection for sudden sensorineural hearing loss.

作者信息

Canakci Hasan, Arslan Erhan, Tulaci KamilGokce, Yazici Hasmet

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University, Balikesir Turkey.

Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University, Balikesir Turkey.

出版信息

Auris Nasus Larynx. 2025 May 7;52(4):314-318. doi: 10.1016/j.anl.2025.04.015.

Abstract

OBJECTIVE

The aim of this study was to investigate the efficacy of a novel intratympanic steroid (ITS) therapy via saturated Gelfoam® (GSD) in sudden sensorineural hearing loss (SSNHL) by comparing with ITS injection therapy.

METHODS

The patients with SSNHL who received initial ITS therapy with no prior systemic steroid treatment were divided into two groups: the ITS via injection group (Group 1) and the ITS via GSD group (Group 2). The groups were compared in terms of the patients' demographic data, side of ear involvement, vertigo and tinnitus symptoms, comorbidities, initiation time of therapy, hearing level (HL) before and after therapy, word recognition score (WRS) before and after therapy, hearing gain (HG), WRS gain (WRSG), recovery rate (RR), tolerability of the applications and complications.

RESULTS

HL and WRS scores were similar among the groups before therapy. Regarding the hearing outcomes after therapy HG and WRSG between the groups were not significant. In the comparison of RR, Group 2's score (70 %) was significantly higher than that of Group 1 (42.4 %) (p = 0.028). In terms of the tolerability of applications, ITS via GSD application was significantly more tolerable than ITS via injection (p = 0.046). Regarding complications, no otorrhea was observed in any patient, and tympanic membrane perforation was observed in 1 patient (3.33 %) in Group 2, whereas no perforation was observed in Group 1.

CONCLUSION

Intratympanic GSD is a simple, effective and tolerable technique in the therapy of SSNHL, with success rates similar to those of ITS injection therapy and significant improvements in the RR scores.

摘要

目的

本研究旨在通过与鼓室内注射类固醇(ITS)疗法进行比较,探讨经饱和明胶海绵(GSD)的新型鼓室内类固醇(ITS)疗法治疗突发性感音神经性听力损失(SSNHL)的疗效。

方法

将首次接受ITS治疗且未接受过全身类固醇治疗的SSNHL患者分为两组:注射ITS组(第1组)和经GSD的ITS组(第2组)。比较两组患者的人口统计学数据、患耳侧别、眩晕和耳鸣症状、合并症、治疗开始时间、治疗前后的听力水平(HL)、治疗前后的单词识别分数(WRS)、听力增益(HG)、WRS增益(WRSG)、恢复率(RR)、治疗的耐受性和并发症。

结果

治疗前两组的HL和WRS分数相似。关于治疗后的听力结果,两组之间的HG和WRSG无显著差异。在RR比较中,第2组的分数(70%)显著高于第1组(42.4%)(p = 0.028)。在治疗的耐受性方面,经GSD应用的ITS比注射ITS的耐受性显著更好(p = 0.046)。关于并发症,所有患者均未观察到耳漏,第2组有1例患者(3.33%)观察到鼓膜穿孔,而第1组未观察到穿孔。

结论

鼓室内GSD是治疗SSNHL的一种简单、有效且耐受性良好的技术,成功率与ITS注射疗法相似,RR分数有显著改善。

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