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

IF 1.4 Q2 OTORHINOLARYNGOLOGY
Sichao Liang, Yunshuo Li, Zhenping Guo, Manlin Lu, Xin Li, Jia Xu, Wenjing Chen, Juanjuan Gao, Haijin Yi
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引用次数: 0

Abstract

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.

经鼓膜管和凝胶泡沫治疗突发性感音神经性听力损失的改良鼓膜内类固醇疗法作为一种挽救性疗法
背景突发性感音神经性听力损失(SSNHL)是耳鼻喉科常见的急症。本研究旨在分析改良的鼓室内类固醇疗法(IST)的疗效,包括插入鼓膜管和凝胶泡沫作为 SSNHL 患者的挽救性治疗,并探讨其相关因素。方法共招募了74名年龄在22-81岁之间的SSNHL患者,并根据其治疗方式分配到对照组(25人)或治疗组(49人)。所有患者都接受了持续至少 7 天的 SST 治疗。随后,治疗组患者在 SST 治疗失败后接受每周两次的 IST 治疗,持续 2-6 周,而对照组患者则不接受 IST 治疗。结果治疗组所有患者在接受 IST 后听力改善为 9.71 ± 14.84 dB,与对照组相比,受影响频率(250-8000 Hz)有显著改善(P <0.05)。研究结果表明,从 SSNHL 发病到 IST 开始的持续时间是治疗后纯音平均改善的独立因素(P = 0.002),而年龄、SST 持续时间和 IST 时间则不是独立因素(P > 0.05)。本研究探讨了改良 IST 方法的疗效,将鼓膜管和凝胶泡沫作为关键组成部分。研究结果凸显了放置在圆窗壁龛中作为战略药物载体的海棉的优势。通过最大限度地减少药物流失、延长作用时间和增加淋巴液浓度,海棉增强了 IST 的治疗效果,有助于改善 SSNHL 患者的听力状况。
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来源期刊
Journal of Otology
Journal of Otology Medicine-Otorhinolaryngology
CiteScore
2.70
自引率
0.00%
发文量
461
审稿时长
18 days
期刊介绍: Journal of Otology is an open access, peer-reviewed journal that publishes research findings from disciplines related to both clinical and basic science aspects of auditory and vestibular system and diseases of the ear. This journal welcomes submissions describing original experimental research that may improve our understanding of the mechanisms underlying problems of basic or clinical significance and treatment of patients with disorders of the auditory and vestibular systems. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines. Journal of Otology welcomes contributions from scholars in all countries and regions across the world.
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