鼓室内注射甲基强的松龙治疗难治性突聋的短期效果观察

A Review of the Short-term Outcomes of Transtympanic Methylprednisolone Injection for Intractable Idiopathic Sudden Sensorineural Hearing Loss

目的研究鼓室内注射甲基强的松龙治疗难治性突发性聋的临床疗效及其并发症。方法选取2006年1月至2007年1月在中山大学附属第二医院耳鼻咽喉科住院治疗的突发性聋患者30例,所有患者均为常规全身用药治疗两周无效,再接受鼓室注射治疗。采用耳内镜辅助下行鼓室内注射甲基强的松龙,每周一次,共三次。治疗结束后一个月复查纯音测听及鼓膜情况,分别比较治疗前后250、500、1 000、2 000、4 000 Hz的听阈,疗效评价采用平均听阈下降10 dB为有效。结果30名患者中,9名有效,有效率30%。治疗后500、1 000、2 000 Hz的平均听阈下降明显,有统计学意义(P<0.01)。无鼓膜穿孔及眩晕、听力下降的病例。结论鼓室内注射激素可作为突发性聋的挽救性治疗方法。

Objective To evaluate the short--term outcomes and related complications of transtympanic methylprednisolone injection for intractable idiopathic sudden sensorineural hearing Ioss（SSNHL）. Methods Stud- ied were 30 patients who had received transtympanic methylprednisolone injection after having failed with intravenous steroids and other medications from Jan 2006 to Feb 2007. They all had received intravenous dexamethasone and other medications for two weeks and no improvement of hearing. The transtympanic methylprednisolone injec- tions were administered with oto--endoscope once a week for 3 weeks. Hearing and tympanic membrane were moni- tered one month after the termination of injections. Hearing improvement was defined as more than 10 dt3 in pure-- tone average （PTA）. Results 9 patients had improvement of hearing （30 % ） according to the PTA. The thresholds of 500, 1 000 and 2 000 Hz decreased obviously （P〈0.01）. No membrane perforation and vertigo were reported, Conclusion Transtympanic methylprednisolone injection can be considered as a salvage treatment for intractable SSNHL.