经咽鼓管鼓室注入地塞米松治疗难治性突发性聋的临床观察

Clinical observation of treatment of intractable sudden deafness by injecting dexamethasone to drum chamber via eustachian tube

目的观察经咽鼓管鼓室内注入地塞米松对难治性突发性聋的治疗效果。方法对36例(36耳)常规治疗无效的突发性聋患者用电子喉镜经咽鼓管口逆向鼓室内注入地塞米松约5 mg,1次/2d,共5次。在治疗开始前1 d和治疗结束后3 d,分别测试受治疗耳的纯音听阈,比较受损频率纯音听阈均值(PTA),下降15 dB HL以上为有效。结果 36例经治患者20例有效,16例无效,有效率为55.56%。治疗前PTA为(71.63±10.60)dB HL,治疗后为(43.07±12.33)dB HL,治疗后比治疗前明显降低(P<0.05)。结论经咽鼓管逆行鼓室内注入地塞米松可作为常规治疗无效的突发性聋患者的再次挽救治疗的有效手段,也可以作为对激素治疗有禁忌证的突发性聋患者的治疗方法。

Objective To observe the efficacy of treatment of intractable sudden deafness by injecting dexamethasone to drum chamber via eustachian tube. Methods Dexamethasone 5 mg was injected to drum chamber via drum chamber under video laryngoscope in 36 cases（36 ears） for whom routine therapy is ineffective. The pure tone hearing thresholds of injected ears were tested at 1 days before and at 3 days after treatment respectively. The limiting mean of pure tone audiometry（PTA） in impaired fraquency was compared, decreasing more than 15 dB HL was defined as effective. Results 20 cases were effective, 16 casese were ineffective in 36 cases. The effective rate was 55.56%. PTA was （71.63 ± 10. 60）dB HL before treatment, PTA was （43.07 ±12. 33 ）dB HL after treatment. There was a significant decrease （P 〈 0. 05 ）. Conclusion Injecting dexamethasone to drum chamber via drum chamber is a effective secondly therapeutic mean for sudden deafness patients for whom routine therapy is ineffective, also can be used for treating sudden deafness patients with contraindication to hormone therapy.