鼓室内注射地塞米松治疗难治性突发性聋

Intratympanic dexamethasone injection in treating refractory sudden sensorineural hearing loss

目的探讨鼓室内注射地塞米松治疗伴有糖尿病、高血压的突发性耳聋（难治性突发性耳聋）患者的疗效。方法观察组35例（35耳）,高血压13例,糖尿病15例,7例高血压加糖尿病。鼓室内注射地塞米松溶液5mg,隔日注射一次,共注射5次。对照组71例（71耳）,静脉注射地塞米松10mg,连续7天,后减为5mg治疗7天。结果观察组：35例,有效率为77.14%（27/35）。对照组：有效率为80.28%（57/71）。两组比较χ^2=0.14,P〉0.05,差异无统计学意义;观察组耳鸣消失率为78.57%（22/28）;对照组耳鸣消失率为71.15%（37/52）。两组比较χ^2=0.52,P〉0.05,差异无统计学意义;两组患者眩晕均全部消失。结论在不能全身使用激素的情况下,采用鼓室内注射的途径可以获得相同的治疗效果,至少是一种备选方案。

Objective To analyze the effect of intratympanic dexamethasone injection（ITDI） in sudden sensorineural hearing loss with diabetes and hypertension（refractory sudden sensorineural hearing loss, RSSNHL）. Methods There were 35 patients（35 ears）in the treatment group, including 13 cases of hypertension, 15 cases of diabetes and 7 cases of hypertension with diabetes. They received intratympanic dexamethasone injection（5mg/d, qod ×5 times）. The 71 patients（71 ears） of the control group received intravenous dexamethasone injection（10mg/d, qd ×7ds, then 5mg/d, qd ×7ds）. Results Hearing improvement was observed in 27（77.14%） in the treatment group and 57（80.28%） in the control group, and without significant difference between the two groups（χ^2=0.14, P 0.05）. The tinnitus disappearance rate was observed 78.57% in the treatment group and 71.15% in the control group, and also without significant difference（χ^2=0.52, P〉0.05）. Vertigo had disappeared in all cases. Conclusions Intratympanic dexamethasone injection could have the identical effectiveness for refractory sudden sensorineural hearing loss in case of impossible use of general steroid treatment.