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鼓室内及耳后注射琥珀酸甲泼尼龙治疗糖尿病患者难治性突发性感音神经性听力损失的疗效

Therapeutic effectiveness of intratympanic and retroauricular methylprednisolone sodium succinate for refractory sudden sensorineural hearing loss in diabetic patients.

作者信息

Li Dong, Qiao Fei, Dai Jun, Xu Min, Gong He-Yan, Yang Hui-Ming, Li Jing-Cheng, Huai De

机构信息

Department of Otorhinolaryngology Head and Neck surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University (The Second People's Hospital of Huai'an), Huai'an 223002, Jiangsu Province, China.

Department of Otolaryngology Head and Neck Surgery, Jinhu County People's Hospital, Huai'an 211600, Jiangsu Province, China.

出版信息

World J Diabetes. 2025 May 15;16(5):99576. doi: 10.4239/wjd.v16.i5.99576.

Abstract

BACKGROUND

Managing refractory sudden sensorineural hearing loss (RSSHL) in patients with diabetes mellitus (DM) presents significant therapeutic challenges, highlighting the importance of identifying effective treatment strategies.

AIM

To analyze the therapeutic effectiveness of intratympanic injection plus retroauricular injection for RSSHL complicated with DM.

METHODS

This study included 84 patients with RSSHL complicated with DM from April 2021 to April 2024, all receiving routine treatment. Participants were categorized into the control group (40 cases), receiving an intratympanic injection of methylprednisolone sodium succinate (MPSS), and the research group (44 cases), treated with retroauricular MPSS injection the next day in addition to the treatment administered in the control group. The efficacy, adverse reactions (tympanic membrane perforation, middle ear infections, burning sensation, vertigo, and tinnitus), blood glucose (BG) [fasting BG (FBG), 2-hour postprandial BG (2hPBG), and glycosylated hemoglobin (HbA1c)], hearing thresholds at different frequencies (250 Hz, 500 Hz, and 1000 Hz), serum biochemical indexes [interleukin (IL)-6, C-reactive protein (CRP), and procalcitonin (PCT)], and quality of life assessed by the short-form 36 item health survey (SF-36) were comparatively analyzed.

RESULTS

The research group demonstrated a markedly higher total effectiveness rate (81.82% 60.00%, = 0.027) and a comparable incidence of total adverse reactions than the control group. Further, the research group exhibited notably reduced FBG, 2hPBG, HbA1c, IL-6, CRP, and PCT post-treatment ( < 0.01), which were lower compared with the pre-treatment levels and the control group ( < 0.05), as well as reduced hearing thresholds at different frequencies (250 Hz, 500 Hz, and 1000 Hz, < 0.05). Furthermore, the post-treatment SF-36 scores of the research group in terms of energy, social functioning, role functioning, physical functioning, mental health, and overall health were all significantly improved than the pre-treatment levels and the control group ( < 0.05).

CONCLUSION

The above results indicate that intratympanic plus retroauricular injections of MPSS are effective in treating RSSHL complicated with DM without increasing the incidence of adverse reactions, which has a health promotion value.

摘要

背景

糖尿病(DM)患者难治性突发性感音神经性听力损失(RSSHL)的管理面临重大治疗挑战,凸显了确定有效治疗策略的重要性。

目的

分析鼓室内注射联合耳后注射治疗合并DM的RSSHL的疗效。

方法

本研究纳入了2021年4月至2024年4月的84例合并DM的RSSHL患者,均接受常规治疗。参与者分为对照组(40例),接受鼓室内注射甲泼尼龙琥珀酸钠(MPSS),研究组(44例),除接受对照组的治疗外,次日加用耳后MPSS注射。比较分析疗效、不良反应(鼓膜穿孔、中耳感染、烧灼感、眩晕和耳鸣)、血糖(BG)[空腹血糖(FBG)、餐后2小时血糖(2hPBG)和糖化血红蛋白(HbA1c)]、不同频率(250Hz、500Hz和1000Hz)的听力阈值、血清生化指标[白细胞介素(IL)-6、C反应蛋白(CRP)和降钙素原(PCT)]以及通过简短36项健康调查(SF-36)评估的生活质量。

结果

研究组的总有效率显著高于对照组(81.82%对60.00%,P = 0.027),且总不良反应发生率与对照组相当。此外,研究组治疗后FBG、2hPBG、HbA1c、IL-6、CRP和PCT显著降低(P < 0.01),低于治疗前水平和对照组(P < 0.05),不同频率(250Hz、500Hz和1000Hz)的听力阈值也降低(P < 0.05)。此外,研究组治疗后的SF-36评分在精力、社会功能、角色功能、身体功能、心理健康和总体健康方面均显著高于治疗前水平和对照组(P < 0.05)。

结论

上述结果表明,鼓室内加耳后注射MPSS治疗合并DM的RSSHL有效,且不增加不良反应发生率,具有促进健康的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d58/12142188/4cf69cbe136a/99576-g001.jpg

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