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 o...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.展开更多
目的利用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)技术低频振幅(amplitude of low-frequency fluctuation,ALFF)和局部一致性(regional homogeneity,ReHo)的方法探讨单侧突发性聋患者急性...目的利用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)技术低频振幅(amplitude of low-frequency fluctuation,ALFF)和局部一致性(regional homogeneity,ReHo)的方法探讨单侧突发性聋患者急性期内静息态脑活动的变化。材料与方法选取单侧突发性聋急性期患者23例和健康对照者18例(健康对照组),进行rs-fMRI扫描,采用ALFF、ReHo两种方法分析患者内在脑活动水平的改变,并提取差异有统计学意义的脑区与临床数据进行相关性分析。结果与健康对照组相比,患者ALFF值增高的脑区有同侧颞中回、脑岛、缘上回和对侧额下回,ALFF值降低的脑区有对侧梭状回、颞中回、中央后回(P<0.001)。ReHo增高的脑区有对侧小脑下叶及同侧颞中回、额中回,减低的脑区有同侧枕上回及对侧额中回(P<0.001)。相关性分析显示,患者同侧颞中回、缘上回ALFF值与纯音测听(Pure Tone Audiometry,PTA)和简易智力状况检查(Mini-Mental State Examination,MMSE)评分呈正相关(P<0.05),左侧颞中回ReHo值与PTA结果呈正相关,左侧额中回ReHo值与MMSE评分呈正相关(P<0.05);左侧枕上回ReHo值与抑郁自评量表(Self-rating Depression Scale,SDS)评分呈正相关(P<0.05)。结论单侧突发性聋患者存在听觉与非听觉的某些脑区脑功能活动的改变,涉及默认网络、突显网络和视听觉网络三个主要网络,可能与突发性聋的发病有关。展开更多
文摘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.
文摘目的利用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)技术低频振幅(amplitude of low-frequency fluctuation,ALFF)和局部一致性(regional homogeneity,ReHo)的方法探讨单侧突发性聋患者急性期内静息态脑活动的变化。材料与方法选取单侧突发性聋急性期患者23例和健康对照者18例(健康对照组),进行rs-fMRI扫描,采用ALFF、ReHo两种方法分析患者内在脑活动水平的改变,并提取差异有统计学意义的脑区与临床数据进行相关性分析。结果与健康对照组相比,患者ALFF值增高的脑区有同侧颞中回、脑岛、缘上回和对侧额下回,ALFF值降低的脑区有对侧梭状回、颞中回、中央后回(P<0.001)。ReHo增高的脑区有对侧小脑下叶及同侧颞中回、额中回,减低的脑区有同侧枕上回及对侧额中回(P<0.001)。相关性分析显示,患者同侧颞中回、缘上回ALFF值与纯音测听(Pure Tone Audiometry,PTA)和简易智力状况检查(Mini-Mental State Examination,MMSE)评分呈正相关(P<0.05),左侧颞中回ReHo值与PTA结果呈正相关,左侧额中回ReHo值与MMSE评分呈正相关(P<0.05);左侧枕上回ReHo值与抑郁自评量表(Self-rating Depression Scale,SDS)评分呈正相关(P<0.05)。结论单侧突发性聋患者存在听觉与非听觉的某些脑区脑功能活动的改变,涉及默认网络、突显网络和视听觉网络三个主要网络,可能与突发性聋的发病有关。
