Intratympanic Steroids in Severe to Profound Sudden Sensorineural Hearing Loss as Salvage Treatment
Intratympanic Steroids in Severe to Profound Sudden Sensorineural Hearing Loss as Salvage Treatment
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DOI：
10.3342/ceo.2010.3.3.122
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发表时间：
2010-09-01
影响因子：
3
通讯作者：
Lee, Byung Don
中科院分区：
文献类型：
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作者：
Lee, Jong Dae;Park, Moo Kyun;Lee, Byung Don
目标。在系统治疗失败后，鼓室内类固醇正越来越多地被用于治疗突发性感音神经性耳聋(SSNHL)。本研究评价鼓室内注射地塞米松(ITD)抢救重度至重度SSHL的疗效。我们回顾了2007年1月至2009年12月期间出现严重至严重SSNHL的患者的医疗记录。ITD在最初的系统治疗后大约14天给予。根据Sigel的标准，成功恢复定义为完全恢复或部分恢复。我们比较了重度SSNHL(S-SSNHL)组和深度SSNHL(P-SSNHL)组的治疗结果。S-单侧非霍奇金淋巴瘤组的疗效明显优于单侧非霍奇金淋巴瘤组(P=0.017)。经系统治疗后，S组痊愈率为36%(9/25)，P组为18.1%(4/22)(P=0.207)。经统计学处理，S-SSNHL组抢救LID的有效率为37.5%(6/16)，P-SSNHL组为5.5%(1/18)(P=0.03)。与S非霍奇金淋巴瘤患者相比，我们的比较研究并不支持益气养阴汤作为抢救治疗的疗效。我们建议P-SSNHL患者了解ITD作为一种抢救治疗的低疗效。
Objectives. Intratympanic steroids are being increasingly used in the treatment of sudden sensorineural hearing loss (SSNHL) after the failure of systemic therapy. This study evaluated the efficacy of administering intratympanic dexamethasone (ITD) as a salvage treatment for severe to profound SSNHL.Methods. We reviewed the medical records of patients who presented with severe to profound SSNHL between January 2007 and December 2009. ITD was given about 14 days after the initial systemic treatment. Successful recovery was defined as complete or partial recovery using Sigel's criteria. We compared the results of treatment between the severe SSNHL (S-SSNHL) and profound SSNHL (P-SSNHL) groups.Results. All the patients in the S-SSNHL group showed significant improvement, as compared to the P-SSNHL group (P=0.017). The recovery rate after the initial systemic treatment was 36% (9/25) in the S-SSNHL group and 18.1% (4/22) in the P-SSNHL group (P=0.207). In comparison, the recovery rate of LID as a salvage treatment was 37.5% (6/16) in the S-SSNHL group and 5.5% (1/18) in the P-SSNHL group (P=0.03).Conclusion. Our comparative study dose not support the efficacy of YID as salvage treatment for patients with P-SSNHL as compared with that for S-SSNHL. We recommend that patients with P-SSNHL be informed about the low efficacy of ITD as a salvage treatment.