鼓室内注射激素作为补充治疗或初始治疗突发性聋的疗效分析

Efficacy of intratympanic steroid injection as supplementary or initial treatment for sudden sensorineural hearing loss

目的:观察鼓室内注射激素作为补充治疗或初始治疗突发性聋的疗效。方法:68例被确诊为突发性聋的患者被随机分为A组45例(其中全身用激素33例,全身用激素后听力改善不佳再鼓室内注射激素作为补充治疗12例)、B组23例(鼓室内注射激素初始治疗),观察各组疗效。结果:A、B两组总有效率分别为55.6%和56.5%,2组比较差异无统计学意义(P>0.05)。A组中全身使用激素后听力改善不佳再鼓室内注射激素作为补充治疗的12例患者鼓室内注射激素前后PTA差异有统计学意义(P<0.05)。结论:全身或鼓室内注射激素治疗突发性聋均有效,鼓室内注射激素补充治疗或初始治疗突发性聋与全身用激素疗效相同,推荐将鼓室内注射激素作为全身激素治疗后疗效欠佳的补充治疗,亦可作为初始治疗。

Objective： To observe the efficacy of intratympanic steroid injection as supplementary or initial treatment for sudden sensorineural hearing loss （SSNHL）. Method： A total of 68 patients diagnosed with SSNHL were randomized into group A （45 cases including systemic steroid for 33 cases and systemic steroid q- intratym- panic steroid as supplementary treatment for 12 cases） and group B （23 cases, initial intratympanic steroid）. Then observe the therapeutic effect in two groups. Result：The total effective rate was 55.6 % in group A and 56.5 % in group B. No statistical difference was detected between these two groups （P〉0. 05）. There was statistical difference after therapy of intratympanic steroid as supplementary treatment for 12 patients due to poor hearing improvement after systemic steroid in group A （P〈0.05）. Conclusion： Both systemic and intratympanic steroid iniection for SSNHL are effective. The efficiency of intratympanic steroid injection as supplementary or initial treatment for SSNHL is similar to that of systemic steroid. The intratympanic steroid injection for SSNHL as initial protocol or as supplementary treatment when poor hearing improvement after systemic steroid is recommended.