鼓室内注射地塞米松治疗急性低频型听力损失  

Intratympanic Dexamethasone in the Treatment of Acute Low-Frequency Hearing Loss

作　　者：费捷[1,2] 周卫东[2] 李继红[2] 

机构地区：[1]南京大学医学院,南京210093 [2]无锡市人民医院耳鼻咽喉科

出　　处：《听力学及言语疾病杂志》2010年第2期150-152,共3页Journal of Audiology and Speech Pathology

摘　　要：目的探讨鼓室内注射地塞米松对常规治疗无效的急性低频型听力损失的疗效。方法37例（38耳）经地塞米松及血管扩张剂静脉给药治疗无效的急性低频型听力损失患者，按就诊顺序分为治疗组及对照组。治疗组19例（20耳）．男7例（7耳），女12例（13耳），单侧18例，双侧1例，患侧鼓室内注射5mg／ml地塞米松（0．5～0．8ml）。每天1次，共7天。对照组18例（18耳），男5例（5耳），女13例（13耳），静脉滴注血管扩张剂7天。治疗前后测试两组患者的低频（125、250、500Hz）平均听阈，并进行统计学分析。所有患者随访1～2年。结果治疗过程中无不良反应发生。治疗组18例单侧患者治愈8例（8耳），有效7例（7耳），有效率83．3％，无效3例（3耳），1例双侧患者治疗无效，2例在随访中再次出现低频听力下降。对照组18例（18耳）治愈3例（3耳），有效5例（5耳），有效率44．4％，无效10例（10耳），5例患者在随访中复发，其中1例最后确诊为梅尼埃病。两组单侧患者的有效率比较差异有统计学意义（P〈0．05）。治疗组治疗后125、250、500Hz平均听阈均低于对照组，差异有统计学意义（P〈0．05）。结论对于全身应用糖皮质激素及扩管药治疗无效的急性低频型听力损失患者，鼓室内注射地塞米松是安全有效的。Objective To explore the efficacy of intratympanic dexamethasone injection in treating acute low -frequency hearing loss（ALHL）. Methods Thirty-seven ALHL cases not responsive to intravenous dexamethasone and vasodilator medications were enrolled in the study and divided into two groups. In the treatment group, dexamethasone was injected intratympanically once per day to 18 cases for a seven day history with unilateral ALHL and 1 case with bilateral ALHL. In the control group, 18 cases with unilateral ALHL were given intravenous vasodilator medications for 7 days. All patients were followed up for 1 - 2 years. Results In the treatment group with unilateral ALHL 8 cases achieved complete recovery, 7 cases achieved partial recovery and no change was observed in the other 3 cases. The efficiency was 83.3%. 2 cases showed recurrent low--frequency hearing loss during the follow--up period. One case with bilateral ALHL. did not respond to the treatment and no recurrence was observed. No side effect was observed in the study. In the control group, 3 cases completely recovered, 5 cases par-tially recovered and 10 cases showed no improvement. The efficiency was 44.4% 5 cases recurred and one of them progressed to Meniere＇s disease. There was a statistically significant difference in efficiency of patients with unilateral ALHL between two groups（P 〈 0.05）. Conclusion Intratympanic dexamethasone application was an effective and safe treatment option for ALHL.

关 键 词：低频 听力损失 鼓室 地塞米松 

分 类 号：R764.431[医药卫生—耳鼻咽喉科]