Efficacy analysis of intratympanic injection of dexamethasone at different concentrations for the treatment of unilateral idiopathic sudden sensorineural hearing loss

IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY
Shi-yi Wang , Wen-ting Fu , Meng Yu , Aidong Sun , Jingwu Sun , Guang Li
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Abstract

Objective

Our study tried to evaluate and compare the therapeutic efficacy of intratympanic injection of dexamethasone (DEX) at different concentrations for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL).

Methods

A prospective randomized controlled study was conducted on 203 patients with unilateral ISSNHL. Patients were divided into four groups: the control group (n = 47, systemic treatment only), the high-concentration group (n = 51, intratympanic injection of DEX 20 mg/ml), the medium-concentration group (n = 55, 10 mg/ml), and the low-concentration group (n = 50, 5 mg/ml). Pure tone audiometry (PTA) thresholds were measured before treatment and on the 10th day post-treatment, with a follow-up period of 2 months. Hearing gains and efficacy rates were compared among the groups.

Results

Significant differences were observed in PTA thresholds before and after treatment in all four groups (P < 0.05), indicating that both systemic therapy and intratympanic injection were effective. The overall efficacy rate and hearing gain were higher in the intratympanic injection groups compared to the control group, but the differences were not statistically significant. Specifically, the control group achieved an efficacy rate of 57.4 % with a hearing gain of 11.25 ± 10.00 dB HL. The intratympanic injection groups showed an overall efficacy rate of 67.3 % and a hearing gain of 12.50 ± 10.94 dB HL, with subgroup results as follows: low-concentration group (62.0 %, 12.50 ± 11.56 dB HL), medium-concentration group (69.1 %, 11.25 ± 13.75 dB HL), and high-concentration group (70.6 %, 12.50 ± 8.75 dB HL). Among patients with severe or profound hearing loss, the high-concentration group exhibited significantly greater hearing gains compared to the control group, while no significant differences were observed in efficacy rates.

Conclusion

Combined intratympanic injection of DEX with systemic treatment for SSNHL provides higher hearing gains and efficacy rates compared to systemic treatment alone, though the differences were not statistically significant. In patients with severe or profound hearing loss, intratympanic injection of high-concentration DEX resulted in significantly greater hearing improvement, suggesting a potential therapeutic advantage in this subgroup.
不同浓度地塞米松鼓室内注射治疗单侧特发性突发性感音神经性耳聋的疗效分析。
目的:评价和比较不同浓度地塞米松鼓室内注射治疗特发性突发性感音神经性听力损失(ISSNHL)的疗效。方法:对203例单侧ISSNHL患者进行前瞻性随机对照研究。将患者分为4组:对照组(n = 47,仅全身治疗)、高浓度组(n = 51,鼓室内注射DEX 20 mg/ml)、中浓度组(n = 55、10 mg/ml)、低浓度组(n = 50、5 mg/ml)。治疗前及治疗后第10天测定纯音听力学(PTA)阈值,随访2个月。比较两组患者的听力增益和有效率。结果:四组患者治疗前后PTA阈值差异均有统计学意义(P)。结论:腹膜内注射DEX联合全身治疗SSNHL的听力增益和有效率高于单独全身治疗,但差异无统计学意义。在重度或重度听力损失患者中,鼓室内注射高浓度DEX可显著提高听力改善,提示该亚组具有潜在的治疗优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal of Otolaryngology
American Journal of Otolaryngology 医学-耳鼻喉科学
CiteScore
4.40
自引率
4.00%
发文量
378
审稿时长
41 days
期刊介绍: Be fully informed about developments in otology, neurotology, audiology, rhinology, allergy, laryngology, speech science, bronchoesophagology, facial plastic surgery, and head and neck surgery. Featured sections include original contributions, grand rounds, current reviews, case reports and socioeconomics.
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