地塞米松鼓室内注射补救治疗突发性聋

Effectiveness of Intratympanic Dexamethasone Injection in Sudden Deafness Patients as Salvage Treatment

目的观察地塞米松鼓室内注射对经过常规治疗没有痊愈或无效的突发性聋的疗效。方法选择门诊经过常规治疗没有痊愈的突发性聋患者45耳,随机分成2组,实验组21耳,地塞米松经鼓膜穿刺鼓室内注射2毫克/次,2次(一周)一个疗程;对照组24耳,给谷维素及复合维生素B口服,用药一周。观察治疗前后纯音听阈及耳鸣、耳闷感的变化情况。结果纯音测听结果显示实验组6耳有效(6/21),对照组1耳有效(1/24),两组比较差异有统计学意义(P<0.05);耳鸣改善实验组有5耳(5/15),对照组1耳(1/19),两组比较差异有统计学意义(P<0.05);耳闷感改善实验组有3耳(3/11),对照组1耳(1/13),两组比较差异无统计学意义(P>0.05)。结论地塞米松鼓室内注射可以改善常规治疗没有痊愈的突发性聋患者的听力及耳鸣症状。

Objective To study the effectiveness of intratympanic dexamethasone injection as the final treatment to sudden deafness patients after conventional treatment failed. Methods Patients who met the criteria for idiopathic sudden sensorineural heating loss（ISSHL） and showed poor response to conventional therapy were assigned randomly to a control group and a group receiving IT- DEX. Injections were performed twice a week for one week. Pure tone audiometry was performed before each injection. Results After treatment, 6 of 21 patients demonstrated heating improvement in IT - DEX group and lof 24 in control group; 5 of 15 patients demonstrated tinnitus improvement in IT- DEX group and 1 of 19 in control group; 3 of 11 patients demonstrated fullness improvement in IT- DEX group and 1 of 13 in control group. Conclusion Intratympanic dexamethasone injection in sudden deafness patients may improve heating and tinnitus and patients who showed effective after conventional therapy display better responses to IT- DEX injections than other patients.