耳后注射复方倍他米松治疗顽固性低频型感音神经性聋

Postaurical injection of compound betamethasone to treat the intractable low-frequency sensorineural hearing loss

目的探讨复方倍他米松注射液对顽固性低频型感音神经性聋的治疗作用。方法对23例单侧低频型感音神经性聋的患者耳后注射复方倍他米松注射液1次,剂量1ml,观察疗效,随访至少6个月以上;同时对4例双侧低频型感音神经性聋的患者进行了相同的治疗。对照组18例单侧低频型感音神经性聋的患者用口服西比灵+敏使朗治疗2周,随访2个月。结果 23例单耳患者中12耳痊愈,7耳听力改善(有效率82.6%),4耳无效。有2例(2耳)患者2～3个月后重新出现低频听力下降的症状。其余患者随访6个月,没有复发。除1例患者耳后局部注射处发现轻度的皮肤萎缩,未发现其他不良反应。4例双侧发病的患者,2例有效,2例无效。2例有效的患者1～2个月后症状复发。对照组18例患者中3例(3耳)停药1周后痊愈,1例(1耳)停药2周后痊愈,随访2个月,没有复发。其余14例无效。结论耳后注射复方倍他米松注射液可以有效地治疗顽固性低频型感音神经性聋,但是对双侧患者疗效差,可能双侧患者多与自身免疫性内耳病有关。

Objective To discuss the treatment of compound betamethasone injection in cases with the intractable low-frequency sensorineural hearing loss （LFSNHL）. Methods Compound betamethasone injection 1 ml had been injected postaural only once to 23 cases with the unilateral LFSNHL,then observe the effect and follow-up at least 6 monthes. At the same time,the same therapy used to 4 cases with the binaural LFSNHL The control group gave Merislon and Sibelium peroral for 2 weeks to 18 cases with the unilateral LFSNHL Results In unilateral LFSNHL group, twelve cases recovered, 7 cases had the hearing improved and 4 cases were ineffective in 23 cases. The efficiency was 82. 6%. 2 cases （2 ears） showed hearing falling at low-frequence after 2-3 monthes. Others didn＇t recur after 6 monthes. 1 case showed low-grade skin atrophy at the local imjection part. No other side-effects showed. In 4 binaural cases,2 cases in effect and the others had no effect ,and the former recurred after 1-2 monthes. In control group, 1 week after the end of therapy,3 cases （3 ears） recovered , 1 case （ 1 ear） recovered 2 weeks later after the end of therapy, and the 4 cases didn＇t recur after 2 monthes The other 14 cases were ineffective. Conclusions Compound betamethasone injection postaural treated intractable LFSNHL effectively, but no obvious efficiency to cases with the binaural LFSNHL may be these cases have some relationship with autoimmune inner ear disease （AIED）.