耳内镜引导下导管法咽鼓管吹张激素治疗突发性聋的疗效观察

Observation on the efficacy of Eustachian tube dilation hormone under the guidance of endoscope in the treatment of sudden deafness

目的:评估耳内镜引导下导管法咽鼓管吹张激素治疗突发性聋患者的疗效。方法:选取2020年1月—2020年12月就诊于陕西省人民医院耳鼻咽喉头颈外科的突发性聋高频下降型患者,根据纳入及排除标准纳入176例患者(185耳)作为研究对象,以随机数字表法分成对照组86例(90耳)和研究组90例(95耳)。对照组予以鼓室注射甲泼尼龙(即注射用甲泼尼龙琥珀酸钠)治疗,研究组用耳内镜下咽鼓管鼓室吹张甲泼尼龙治疗,比较两组患者治疗前后纯音听阈值、有效率及用药期间不良反应发生率。结果:研究组治疗总有效率为84.21%(80/95),略低于对照组的有效率84.44%(76/90),但两组比较差异无统计学意义(P>0.05)。两组纯音听阈值较治疗前明显提高,研究组听力平均提高(25.47±6.29)dB,略低于对照组(27.33±7.55)dB,两组比较差异无统计学意义(P>0.05);两组治疗方式出现轻微不良反应的发生率比较,差异无统计学意义(P>0.05)。均未出现严重不良反应。结论:耳内镜下咽鼓管鼓室吹张激素治疗突发性聋患者在治疗总有效率、听力提高水平、不良反应率等方面与鼓室注射激素治疗效果相同。

Objective:To evaluate the efficacy of Eustachian tube dilation hormone under the guidance of otoscope in the treatment of patients with sudden deafness.Methods:One hundred and seventy-six patients(185 ears)with sudden deafness treated by otorhinolaryngology head and neck surgery in Shaanxi Provincial People’s Hospital from January 2020 to December 2020 were selected.According to the inclusion and exclusion criteria,176 patients(185 ears)were randomly divided into control group(n=86,90 ears)and study group(n=90,95 ears).The control group was treated with intratympanic injection of methylprednisolone(methylprednisolone sodium succinate for injection),and the study group was treated with tympanic tympanoplasty under otoendoscope.The pure tone hearing threshold,effective rate and the incidence of adverse reactions were compared between the two groups before and after treatment.Results:The total effective rate of the study group was 84.21%(80/95),slightly lower than that of the control group(84.44%),but there was no significant difference between the two groups.The hearing threshold of pure tone in the two groups was significantly higher than that before treatment,and the average improvement of hearing in the study group(25.47±6.29)dB was slightly lower than that in the control group(27.33±7.55)dB,but there was no significant difference between the two groups(P>0.05).There was no significant difference in the incidence of mild adverse reactions between the two groups(P>0.05).There were no serious adverse reactions.Conclusion:The total effective rate,hearing improvement level and adverse reaction rate of patients with sudden deafness treated with Eustachian tube tympanic dilatation hormone under endoscope are the same as that of tympanic hormone injection.