Controlled release of dexamethasone from fibrin sealant for intratympanic administration in inner ear therapy

The aim of the present work was to show the sustainability of fibrin sealant in releasing dexamethasone and adjust the protocol for clinical application of the novel method in the treatment of Meniere’s disease (MD) and sudden sensorineural hearing loss (SSHL).Gelation occurred shortly after mixing dexamethasone-containing fibrinogen with thrombin.Dexamethasone was constantly released for at least 16 d at a stable level after 7d in protocol 1 (low-dose),while it was robustly released within 4 d and slowed afterward until 10 d in protocol 2(high-dose).There were significant differences among the time points in Protocol 2 (p<0.01,ANOVA),and the exponential model with the formula y=15.299*e~(-0.483*t) fits the association.The estimated concentration of dexamethasone released on 7 d in protocol 2 was slightly lower than that observed in protocol 1.The fibrin sealant is capable of constantly releasing dexamethasone with adjustable dynamics.Targeted and minimally invasive administration of the material can be achieved in the clinic by sequential injections of the fluids using a soft-tipped catheter.

Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment

Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.

Intratympanic injection of hydrogel nanodrug for the prevention and treatment of sensorineural hearing loss

Safe and efficient drug delivery to the inner ear has always been the focus of prevention and treatment of sensorineural deafness.The rapid development of nanodrug delivery systems based on hydrogel has provided a new opportunity.Among them,thermo-sensitive hydrogels promote the development of new dosage form for intratympanic injection.This smart biomaterial could transform to semisolid phase when the temperature increased.Thermo-sensitive hydrogel nanodrug delivery system is expected to achieve safe,efficient,and sustained inner ear drug administration.This article introduces the key techniques and the latest progress in this field.

鼓室给药临床实践指南

鼓室给药是一种常见的耳科局部给药方式,指通过将药物递送入中耳,经圆窗膜或卵圆窗扩散分布到内耳从而达到治疗或诊断效果。近年来,鼓室给药技术在耳科疾病的临床应用越来越广泛,主要包括突发性聋、梅尼埃病、分泌性中耳炎和自身免疫性内耳病等疾病的诊治。目前,国内外对鼓室给药的操作规范、适应证,尤其是给药时机及治疗方案尚未有统一标准。为了促进鼓室给药技术规范化,我们特组织了国内在鼓室给药领域经验丰富,有卓越建树中青年专家,基于临床经验和循证医学证据制定了鼓室给药临床实践指南。本指南从鼓室给药操作规范出发,系统总结了糖皮质激素鼓室给药、庆大霉素鼓室给药、鼓室内注射造影剂膜迷路MRI成像及其他药物鼓室给药四个方面,旨在指导并规范临床鼓室给药技术的应用。

鼓室内注射糖皮质激素治疗突发性耳聋的疗效及影响因素

目的:探讨鼓室内注射糖皮质激素治疗突发性耳聋(SHL)的疗效及影响因素。方法:选取216例SHL患者为研究对象,根据治疗方式不同分为观察组和对照组,每组各108例;观察组患者再根据治疗效果不同分为治愈组(n=52)和未治愈组(n=56)。观察组采用鼓室内注射糖皮质激素治疗;对照组采用静脉滴注糖皮质激素治疗,疗程均为2周。比较不同治疗方式患者的临床疗效及不同治疗效果患者一般临床资料(性别、年龄、发病时间、患耳部位、合并症、听力损失程度、听力损伤类型),分析影响鼓室内注射糖皮质激素治疗SHL疗效的因素。结果:观察组总有效率高于对照组(87.04%vs.75.93%,P<0.05)。不同治疗效果患者年龄、发病时间、合并眩晕、听力损失程度、听力损伤类型比较,差异有统计学意义(P<0.05)。回归分析显示,患者发病时间、合并眩晕、听力损失程度、听力损伤类型是影响鼓室内注射糖皮质激素治疗SHL疗效的独立因素(P<0.05)。结论:鼓室内注射糖皮质激素治疗SHL疗效好,且治疗效果受发病时间、合并眩晕症、听力损失程度、听力损伤类型等因素影响。

鼓室注射糖皮质激素和高压氧治疗对特发性突发性感音神经性耳聋的疗效

目的 本研究旨在探究鼓室注射糖皮质激素(ITS)和高压氧治疗(HBOT)对全身糖皮质激素(SS)治疗失败的特发性突发性感音神经性耳聋(ISSNHL)患者的临床疗效。方法 回顾性收集2020年1月至2023年1月杭州市临平区第一人民医院耳鼻喉科收治的ISSNHL患者。根据治疗方案,ISSNHL患者分为SS组、HBOT组和ITS组。观察并比较治疗前(T_(0))、治疗第5天(T_(1))、治疗3个月后(T_(2))ISSNHL患者的听力水平[纯音听阈均值(PTA)]和听力增益改变,比较不同组别治疗总有效率。采用单因素分析探索不同治疗方式ISSNHL患者疗效的影响因素。结果 共纳入156例ISSNHL患者,SS组70例、HBOT组33例和ITS组53例。T_(0)时,3组患者在PTA上差异无统计学意义(P>0.05)。T_(2)时,3组ISSNHL患者PTA水平较治疗前显著下降(P<0.05);HBOT组和ITS组PTA水平显著低于SS组(P<0.05);HBOT组PTA水平显著低于ITS组(P<0.05)。HBOT组和ITS组听力增益显著高于SS组(P<0.05),HBOT组听力增益显著高于ITS组(P<0.05)。HBOT组治疗总有效率显著高于ITS组(P<0.05),ITS组治疗总有效率显著高于SS组(P<0.05)。此外,无论何种治疗方案,眩晕均是ISSNHL患者听力恢复不良的影响因素(P<0.05)。结论 ITS和HBOT均可提升SS治疗失败ISSNHL患者的治疗有效率,促进ISSNHL听力恢复。较IST而言,HBOT疗效更为显著,建议临床治疗优先考虑。眩晕均是SS治疗失败ISSNHL患者听力恢复不良的影响因素,应在临床实践中重点关注。

甲泼尼龙琥珀酸钠不同给药方式治疗突发性聋的临床效果

目的:探讨甲泼尼龙琥珀酸钠不同给药方式治疗突发性聋的临床效果。方法:选取2018年1月—2023年10月淄博市临淄区人民医院收治的突发性聋患者120例作为研究对象,采用随机数字表法分为鼓室内注射组与静脉滴注组,各60例。静脉滴注组给予甲泼尼龙琥珀酸钠静脉滴注,鼓室内注射组给予甲泼尼龙琥珀酸钠鼓室内注射。比较两组治疗前后听阈、疗效、不良反应发生情况。结果:治疗前,两组1、2、4kHz听阈比较,差异无统计学意义(P>0.05);治疗后15d,两组1、2、4kHz听阈低于治疗前,鼓室内注射组低于静脉滴注组,差异有统计学意义(P<0.05)。鼓室内注射组治疗总有效率高于静脉滴注组,差异有统计学意义(P=0.027)。静脉滴注组胃肠道反应、水肿发生率高于鼓室内注射组,耳痛发生率低于鼓室内注射组,差异有统计学意义(P<0.05);两组眩晕、鼓膜穿孔发生率比较,差异无统计学意义(P>0.05)。结论:相比于静脉滴注,鼓室内注射甲泼尼龙琥珀酸钠可有效改善患者听力情况,促进患者听力恢复,但是治疗期间可能引起耳痛、鼓膜穿孔等不良反应,治疗时需采取有效措施。

Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid-to high-frequency sudden sensorineural hearing loss

BACKGROUND Sudden sensorineural hearing loss(SSNHL),characterized by a rapid and unexplained loss of hearing,particularly at moderate to high frequencies,presents a significant clinical challenge.The therapeutic use of methylprednisolone sodium succinate(MPSS)via different administration routes,in combination with conventional medications,remains a topic of interest.AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid-to high-frequency SSNHL.METHODS The medical records of 109 patients with mid-to high-frequency SSNHL were analyzed.The patients were divided into three groups based on the route of administration:Group A[intratympanic(IT)injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection],Group B(intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection),and Group C(single IT injection of MPSS).The intervention effects were compared and analyzed.RESULTS The posttreatment auditory thresholds in Group A(21.23±3.34)were significantly lower than those in Groups B(28.52±3.36)and C(30.23±4.21;P<0.05).Group A also exhibited a significantly greater speech recognition rate(92.23±5.34)than Groups B and C.The disappearance time of tinnitus,time to hearing recovery,and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C(P<0.05).The total effective rate in Group A(97.56%)was significantly greater than that in Groups B and C(77.14%and 78.79%,χ^(2)=7.898,P=0.019).Moreover,the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B(4.88%,3.03%vs 2.57%,χ^(2)=11.443,P=0.003),and the recurrence rate in Group A was significantly lower than that in Groups B and C(2.44%vs 20.00%vs 21.21%,χ^(2)=7.120,P=0.028).CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS.This approach effectively improves patients'hearing and reduces the risk of disease recurrence.

鼓室内注射地塞米松联合盐酸氨溴索治疗分泌性中耳炎的效果观察

目的 探讨鼓室内注射地塞米松联合盐酸氨溴索治疗分泌性中耳炎的效果,为临床提供参考。方法 选取2020年1月至2023年3月盐城市第三人民医院收治的80例分泌性中耳炎患者为研究对象,按照随机数字表法分为对照组和观察组,每组40例。两组患者均行鼓膜穿刺抽液,给予对照组患者鼓室内注射地塞米松治疗,给予观察组患者鼓室内注射地塞米松联合盐酸氨溴索治疗。比较两组患者不同频率气导听阈水平、中耳积液炎症因子水平、不良反应发生情况和复发情况。结果 治疗后,两组患者0.5 kHz、1.0 kHz和2.0 kHz气导听阈水平低于治疗前,且观察组均低于对照组(均P<0.05)。治疗后,两组患者肿瘤坏死因子-α(TNF-α)、白细胞介素-5(IL-5)和白细胞介素-8(IL-8)水平低于治疗前,且观察组均低于对照组(均P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05);观察组患者复发率低于对照组(P<0.05)。结论 鼓室内注射地塞米松联合盐酸氨溴索治疗分泌性中耳炎患者效果较好,可改善听力水平,降低炎症因子水平,安全性良好且可降低复发率。

Intratympanic corticosteroids in Ménière's disease:A mini-review

This article reviews the effectiveness of intratympanic corticosteroids for vertigo control in Meniere's disease at 2-years follow-up according to the guidelines expressed by the American Academy of Otolaryngology-Head & Neck Surgery. Despite the increased use of intratympanic corticosteroids for vertigo control in Meniere's disease there is debate as to their effectiveness, particularly compared to gentamicin. Even so,after just a single course of injections, corticosteroids can reliably provide complete vertigo control(Class A) at 2-years in about 50% of cases as indicated in a recent double-blind randomized controlled clinical trial(Patel et al., 2016). But the effectiveness of intratympanic corticosteroids truly increases when treatment is provided 'as-needed', whereby complete vertigo control is established in up to 91% of cases. On the basis of available literature, there is good evidence to recommend the use of intratympanic steroid treatment for vertigo control in Meniere's disease, but patients must be monitored for non-response. The rationale for treating patients as-needed and the possible reasons for corticosteroid nonresponse are discussed.

Idiopathic sudden sensorineural hearing loss:Effectiveness of salvage treatment with low-dose intratympanic dexamethasone

Objectives:To evaluate hearing outcome of salvage treatment with intratympanic steroids(ITS)in idiopathic sudden sensorineural hearing loss(ISSNHL)refractory to initial systemic steroid(SS)therapy.Material and methods:A retrospective medical chart review was conducted on 54 consecutive patients with ISSNHL refractory to SS.Salvage treatment with a low dose intratympanic dexamethasone(4 mg/ml)was offered after one week of primary treatment.Patients were divided into two groups:25 patients accepted ITS(treatment group)and 29 patients did not undergo additional treatment(control group).A pure tone average(PTA)gain of at least 10 dB was considered hearing improvement.Results:Hearing improvement rate was higher in ITS group compared to control group(40%vs.13.8%,p=0.035).A mean PTA improvement of 8.6±9.8 dB was observed in the ITS group and,whereas the control group had an average hearing gain of 0.7±2 dB(p<0.001).Audiometric analysis revealed a significant hearing gain in ITS group at all tested frequencies compared to control group(p<0.05).Analysis of the selected variables,identified intratympanic steroid treatment as the only independent prognostic factor for hearing improvement(OR=4.2,95%CI:1.1e15.7;p=0.04).Conclusion:Intratympanic low dose dexamethasone is effective in patients with incomplete hearing recovery after primary systemic steroid treatment.

A comparison of effects of systemic and intratympanic steroid therapies for sudden sensorineural hearing loss:A meta-analysis

Objective:To evaluate the efficacy and safety of intratympanic and systemic steroid therapies in the initial treatment of Sudden Sensorineural Hearing Loss (SSNHL) patients. Methods:A comprehensive search of PubMed, Wanfang database and CNKI (China National Knowledge Infrastructure) was performed covering the period from January 1990 to July 2014. A meta-analysis was conducted after filtering by the criteria of Cochrane Collaboration. Three hundred fifty six subjects in nine studies allocated to the group of intratympanic steroid therapies and 343 controls receiving systemic steroid therapies met the criteria for meta-analysis. The data were extracted and analyzed using the RevMan 5.3 meta-analysis software. Results: The total effectiveness rate in SSNHL patients receiving intratympanic steroid therapies did not differ statistically from patients receiving systemic therapies (RR ? 1.08, 95%CI ? 0.99e1.99, P ? 0.10), although the rate of full hearing recovery in this group differed significantly from patients receiving systemic therapies (RR ? 1.29, 95%CI ? 1.00e1.66, P ? 0.05). Conclusion: Local steroid therapy appears to generate higher rate of complete hearing recovery than systemic steroid treatment as an initial treatment for SSNHL, which may be especially useful for patients in whom systemic steroids are contraindicated.

Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy

BACKGROUND As sudden sensorineural hearing loss(SSNHL)rarely occurs in pregnant women,there is a lack of knowledge and relevant research on its management.AIM To investigate the effect of intratympanic dexamethasone injection in the treatment of pregnant patients with SSNHL.METHODS A retrospective chart review was made for the period between June 2017 and August 2019 at our Department of Otorhinolaryngology-Head and Neck Surgery.Pregnant women who met the criteria for SSNHL were included and grouped based on the therapeutic modalities.The treatment group received intratympanic dexamethasone(2.5 mg)q.o.d.for a total of four times,while the control group received no medication other than bed rest and medical observations.All the patients were under close care of obstetricians.Pure-tone audiograms were performed before and after treatment.RESULTS Eleven patients who met the inclusion criteria were assigned to the treatment group(n=7)and the control group(n=4).The mean age of patients was 31.2±3.8 years;the right ear was affected in seven(63.64%)cases.Two patients(18.2%)suffered from vertigo,10(90.9%)suffered from tinnitus and 6(54.5%)suffered from aural fullness.The time from onset to clinic visit was relatively short,with a mean time of 1.3±0.9 d.All the women were within the second or third trimester;the average gestation period was 26.0±6.2 wk.The pure-tone averages at onset between the two groups were similar.After one wk of therapy,the treatment group had a curative rate of 57.1%and a significantly better hearing threshold and greater improvement compared to the control group(all P<0.05).Some patients experienced transient discomfort from intratympanic injections that disappeared after getting rest,while none had permanent complications.All patients delivered healthy full-term neonates with an average Apgar score of 9.7±0.5.CONCLUSION Intratympanic dexamethasone injections can be used as a first-line therapy in pregnant women with SSNHL.

Intratympanic vs systemic use of steroids as first-line treatment for sudden hearing loss:A meta-analysis of randomized,controlled trials

Background Sudden sensorineural hearing loss(SSNHL)is a common disease in otology,and steroids play an important role in its treatment.Steroids can be administered systemically or locally,and the efficacies of different administration routes remain controversial.Methods We searched the Cochrane,EMBASE,PubMed,Web of Science,CNKI,Wanfang and Weipu databases for randomized controlled trials(RCTs)on glucocorticoid treatments for SSNHL to compare the efficacy of topical and systemic steroid administration.The Review Manager 5.4 software was used for synthesis of data:the rate of reported hearing improvement and change in pure-tone audiometry(PTA).Results In all the included studies,when intratympanic administration was compared to systemic therapies,the risk difference(RD)using reported hearing improvement as an outcome measure was 0.08(95%CI:0.01–0.14,I2=45%).Using PTA changes as an outcome measure in 4 studies,the mean difference(MD)was 10.43 dB(95%CI:3.68–17.18,I2=81%).Hearing improvement RD was also compared among different types of steroid,recovery criteria,follow-up times and diagnostic criteria,and showed no significant differences exception for recovery criteria(>10 dB)(RD-0.06,95%CI:0.14-0.2,I2=0%).Conclusion As the initial treatment for SSNHL,topical steroids seem to be superior to systemic steroid administration,especially in patients with contraindications to systemic steroids usage.However,further verification based on high-quality research is needed.

Role of Intratympanic Steroids in the Management of Idiopathic Sudden Sensori Neural Hearing Loss— Our Experience of 67 Cases

Objective: To assess the outcomes of intratympanic steroids in the management of idiopathic sudden sensorineural hearing loss. Study Design: Retrospective study. Setting: Academic tertiary care medical centre. Materials and Methods: A total of 67 patients with idiopathic sudden sensorineural hearing loss were included in our study. Pre- and post-injection audiograms were taken to assess the outcomes in improvement in hearing. Hearing outcomes were assessed with respect to duration of onset of treatment and age of the patient. Improvement in the speech discrimination score was also assessed. Results: A total of 67 patients were included in our study of which unilateral cases were 59 and bilateral cases were 8. Subjectively 35 patients reported improvement in hearing after the therapy while objectively we found 44 ears [41 patients] had improvement. The mean PTA pre ITS was 62.7 and after ITS it was 56.3. Maximum improvement was noted at 2000 Hz and 1000 Hz. Conclusion: Intratympanic steroids can be offered as a first line therapy for idiopathic sudden sensorineural hearing loss as it is minimally invasive, and can be performed as an office based procedure with no systemic side effects. No major complications have been reported in our study and results have been satisfactory.

Role of Intratympanic Steroids in the Management of Meniere’s Disease—A Review of 151 Cases

Objective: To assess the outcomes of hearing and vertigo in patients with Meniere’s disease who were treated with intratympanic methylprednisolone. Study Design: Retrospective study. Setting: Tertiary referral hospital. Methods: In our study with 151 patients [191 ears] were diagnosed as Menieres as per 1995 AAO-HNS guidelines. As an office based procedure these patients were treated with intratympanic methyl prednisolone. Results: There was a 98.6% improvement in the vertigo control rate, a 73.82% improvement in hearing and 29.31% had a definitive improvement in tinnitus. Conclusion: We conclude from our study that intratympanic steroid injection significantly controls vertigo, tinnitus and improves hearing in Meniere’s disease with minimal complications. Hence, it can be tried as a first line treatment for patients with Meniere’s disease.

Sudden sensorineural hearing loss treated with intratympanic dexamethasone injection

Objective To evaluate the effect of different protocols of intratympanic dexamethasone injection in patients with unilateral sudden sensorineural hearing loss (SSNHL) who have failed to respond to typical medical treatment (including systemic steroid treatment). Methods From January 2005 to January 2008, 71 patients who were diagnosed with unilateral SSNHL and failed typical medical treatment received intratympanic dexamethasone injection. Four injection protocols were employed: injection of 0.3 ml dexamethasone(5 mg / ml) three times a week for 3 weeks for a total dose of 13.5 mg (Group I, n=16); injection of 0.6 ml (5 mg / ml) dexamethasone three times a week for 3 weeks for a total dose of 27 mg (Group II, n=18); injection at 0.3 ml(5 mg/ml) week for 6 weeks for a total dose of 9 mg (Group III, n=18); injection at 0.3 ml (5 mg / ml) / 2 days for a total dose of 4.5 mg (Group IV n=19). Hearing recovery was assessed by pure tone audiogram. Results The total effective rate was 37.5%, 38.89%, 33.33% and 36.84% for each treatment protocol, respectively, with no statistical difference between them (P > 0.05). The results suggest that a total dose of 4.5 mg (injected once a week for 3 weeks) is the most adequate protocol, and increasing dose or injection frequency yields no additional benefits. Conclusion Intratympanic dexamethasone significantly improves the prognosis of SSNHL. Small dose at low injection frequency is sufficient. Further multicenter studies are needed to determine the standard treatment protocol.

Intratympanic Injections: An Unsolved Mystery

Aims: The aim of this study was to test the effectiveness of intratympanic dexamethasone injections as a treatment for severe disabling tinnitus and also observe its effect on hearing loss if any. Materials and Methods: Thirty patients with severe disabling tinnitus in the age group 20 to 60 years were selected and randomly assigned to receive intratympanic injections of a dexamethasone solution 4 mg/ml (0.5 ml) or isotonic saline (0.5 ml) solution under topical anaesthesia, once per week for 4 weeks using a zero degree endoscope. Improvement in tinnitus was assessed using a visual analog scale, considering 2-point improvement as significant and alteration in hearing if any was noted by pure tone audiometery before and after the therapy. Results: The improvement in tinnitus was not significant, with no alteration in audiometery reports. Conclusions: Intratympanic therapy is an attractive mode of treatment because of its highly targeted delivery, low concentration of the drugs required and a very good patient tolerance. Although there has been no breakthrough in intratympanic therapy for tinnitus or other otological conditions, accessibility to the inner ear through the semipermeable round window membrane holds many promises in the near future.

鼓室内注射地塞米松和盐酸氨溴索治疗分泌性中耳炎

目的 探讨鼓室内联合注射地塞米松和盐酸氨溴索治疗分泌性中耳炎(SOM)患者的疗效及对外周血Th细胞平衡的影响。方法 选取120例SOM单耳患病患者,共120耳。采用简单随机分组法将患者均分为观察组和对照组,每组60例。对照组患者鼓室内注射盐酸氨溴索,观察组鼓室内注射地塞米松和盐酸氨溴索,均持续治疗2周。分别于治疗前后,采用酶联免疫吸附法(enzyme linked immuno sorbent assay, ELISA)检测干扰素-γ(interferon-γ, IFN-γ)、白细胞介素-4(Interleukin-4, IL-4)、白细胞介素-2(Interleukin-2 IL-2)和白细胞介素-10(Interleukin-10, IL^(-1)0)水平,流式细胞术检测表面抗原分化簇3受体(differentiation cluster 3 receptor, CD3+)、表面抗原分化簇4受体(differentiation cluster 4 receptor, CD4+)、表面抗原分化簇8受体(differentiation cluster 8 receptor, CD8+)水平,并计算CD4+/CD8+。记录2组治疗期间的不良反应发生情况。结果 观察组患者有效率(88.33%)明显高于对照组(71.67%),P<0.05;治疗后,观察组患者纯音听阈阈值明显低于对照组(P<0.05);观察组患者血清IL-4、IL^(-1)0、IL-2和IFN-γ水平均明显低于对照组(P<0.05);观察组患者CD3+、CD4+及CD4+/CD8+水平明显高于对照组,CD8+水平明显低于对照组(P<0.05)。观察组患者治疗期间的不良反应发生率(8.33%)与对照组(16.67%)比较差异无统计学意义(P>0.05)。结论 鼓室内联合注射地塞米松和盐酸氨溴索可明显提高SOM患者的临床疗效,提高患者的免疫力。

布地奈德混悬液鼓室内注射治疗突发性耳聋伴糖尿病的临床效果及对血糖、空腹C肽及β_(2)微球蛋白水平的影响

目的探讨布地奈德混悬液鼓室内注射治疗突发性耳聋伴糖尿病的临床效果。方法选取2019年2月至2021年2月于本院诊治的104例突发性耳聋伴糖尿病患者作为研究对象,按照随机数字表法将其分为对照组(n=52,常规综合药物+泼尼松片治疗)和观察组(n=52,常规综合药物+布地奈德混悬液鼓室内注射治疗)。比较两组的治疗效果。结果治疗后,观察组的糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、空腹C肽(FC-P)、β_(2)微球蛋白(β_(2)-MG)水平及血糖异常发生率均低于对照组(P<0.05)。治疗后,观察组的耳鸣视觉模拟评分法(VAS)评分、疼痛VAS评分及纯音气导平均听阈(PTA)均低于对照组(P<0.05)。结论布地奈德混悬液鼓室内注射治疗突发性耳聋伴糖尿病的临床效果较好,可稳定患者的血糖水平,降低其FC-P、β_(2)-MG水平,改善耳鸣、疼痛、听力障碍等症状。