甲强龙鼓室注射治疗难治性突发性耳聋

Intratympanic methylprednisolone medication for intractable sudden sensorineural hearing loss

目的观察鼓室内注射甲强龙治疗难治性突发性耳聋的临床效果和安全性。方法对41例经"序贯疗法"治疗无效突发性耳聋的患者,分为甲强龙组和对照组,其中20例行鼓室注射注入40g/L甲强龙0.5～0.7ml,隔日注射1次,10d为1个疗程。21例为对照组,给予营养神经药物治疗10d,比较2周后4个频率(0.5、1、2、4kHz)气导纯音听阈均值(PTA),下降15dB以上为有效。结果2周后20例鼓室内注射甲强龙前后PTA分别(70.41±16.66)dBHL和(54.23±24.56)dBHL,差异有显著性(P<0.05),总的有效率为40%。甲强龙组和对照组的PTA分别(54.27±24.56)dBHL和(62.50±16.31)dBHL,差异有显著性(P<0.05)。病例未出现鼓室内感染、鼓膜穿孔和听力下降。结论鼓室内注射甲强龙为治疗难治性突发性耳聋安全、有效的方法之一。

Objective To investigate clinical efficiency of intratympanic Methylprednisolone for with intractabl sudden sensorineural hearing loss （SSHL）. Methods Our study consisted of 41 patients with SSHL,who at the end of 14 days of systematical therapy with intravenous steroids as a 1st line treatment, they were randomized into 2 groups, methylprednisolone and control. 20 patients received an course of at least 10 day Methylprednisolone （40 g/L） 0. 5 ~0. 7 ml intratympanic injection; 21 patients received neurotrophis drugs for 10 day. PTA calculated.using air conduction thresholds at 4-frequencies （0. 5, 1,2, and 4 kHz） at pre-treat and post-treat were compared. The change in PTA greater than 15 dB was considered to be effective. Results PTA at pre-treat and post-treat were （70. 41 ± 16. 66）dB HL and（54. 23 ±24. 56）dB HL respectively in methylprednisolone group. There were significant improvement in PTA （ P 〈 0. 05 ）, the improvement in hearing was found in 40% patients. PTA at pretreat and post-treat were （54. 27 ± 24. 56）dB HL and（62. 50 ± 16. 31 ）dB HL in methylprednisolone group and control group, There were significant improvement in PTA （P 〈 0.05 ）, No unexpected adverse events such as otitis media or perforated tympanic membrane or worsening in hearing occurred during the injection or follow-up period. Conclusion Intratympanic Methylprednisolone medication is beneficial in treating patients with intractabl suddenSSHL.