鼓室给药临床实践指南  

Clinical practice guidelines for intratympanic drug delivery

作　　者：蔡沁明 柴人杰 陈钢钢[3] 陈阳 冯宁宇 冷杨名[1] 刘宇鹏[6] 陆玲[7] 任冬冬 汪照炎[9] 王国鹏[10] 王巍[11] 吴学文[12] 夏明 熊浩[14] 徐磊[15] 张宏征[16] 张杰[17] 张天虹[18] 赵宇[19] 孙宇[1] CAI Qinming;CHAI Renjie;CHEN Ganggang;CHEN Yang;FENG Ningyu;LENG Yangming;LIU Yupeng;LU Ling;REN Dongdong;WANG Zhaoyan;WANG Guopeng;WANG Wei;WU Xuewen;XIA Ming;XIONG Hao;XU Lei;ZHANG Hongzheng;ZHANG Jie;ZHANG Tianhong;ZHAO Yu;SUN Yu(Department of Otorhinolaryngology Head and Neck Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Otolaryngology Head and Neck Surgery,Zhongda Hospital,Southeast University,Nanjing 210096,China;Department of Otorhinolaryngology Head and Neck Surgery,First Hospital of Shanxi Medical University,Taiyuan 030012,China;Department of Otolaryngology Head and Neck Surgery,Xijing Hospital,Air Force Medical University,Xi’an 710032,China;Department of Otolaryngology Head and Neck Surgery,First People’s Hospital of Yinchuan,Yinchuan 750004,China;Department of Otorhinolaryngology Head and Neck Surgery,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China;Department of Otolaryngology Head and Neck Surgery,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Otorhinolaryngology,Eye and ENT Hospital of Fudan University,Shanghai 200031,China;Department of Otolaryngology Head and Neck Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China;Department of Otolaryngology Head and Neck Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Otorhinolaryngology Head and Neck Surgery,Tianjin First Central Hospital,Tianjin 300110,China;Department of Otorhinolaryngology Head and Neck Surgery,Xiangya Hospital,Central South University,Changsha 410008 China;Department of Otolaryngology Head and Neck Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Otolaryngology Head and Neck Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Otolaryngology Head

机构地区：[1]华中科技大学同济医学院附属协和医院耳鼻咽喉头颈外科,湖北武汉430022 [2]东南大学附属中大医院耳鼻咽喉头颈外科,江苏南京210096 [3]山西医科大学第一医院耳鼻咽喉头颈外科,山西太原030012 [4]空军军医大学附属西京医院耳鼻咽喉头颈外科,陕西西安710032 [5]银川市第一人民医院耳鼻咽喉头颈外科,宁夏银川750004 [6]上海交通大学医学院附属新华医院耳鼻咽喉头颈外科,上海200092 [7]南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科,江苏南京210008 [8]复旦大学附属眼耳鼻喉科医院耳鼻咽喉科,上海200031 [9]上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科,上海200011 [10]首都医科大学附属北京友谊医院耳鼻咽喉头颈外科,北京100050 [11]天津市第一中心医院耳鼻咽喉头颈外科,天津300110 [12]中南大学湘雅医院耳鼻咽喉头颈外科,湖南长沙410008 [13]山东第一医科大学附属省立医院耳鼻咽喉头颈外科,山东济南250021 [14]中山大学孙逸仙纪念医院耳鼻咽喉头颈外科,广东广州510120 [15]山东大学山东省耳鼻喉医院耳鼻咽喉头颈外科,山东济南250299 [16]南方医科大学珠江医院耳鼻咽喉头颈外科,广东广州510282 [17]首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,北京100045 [18]哈尔滨医科大学附属第一医院耳鼻咽喉头颈外科,黑龙江哈尔滨150007 [19]四川大学华西医院耳鼻咽喉头颈外科,四川成都610044

出　　处：《中国耳鼻咽喉颅底外科杂志》2024年第1期1-11,共11页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：湖北省自然科学基金计划创新群体项目(2023AFA038);国家自然科学基金(82071058、82101231、82071059);国家重点研发计划(2021YFF0702300、2023YFE0203200);湖南省自然科学基金(2018JJ3842);上海市耳鼻疾病转化医学重点实验室开放课题基金(14DZ2260300)。

摘　　要：鼓室给药是一种常见的耳科局部给药方式,指通过将药物递送入中耳,经圆窗膜或卵圆窗扩散分布到内耳从而达到治疗或诊断效果。近年来,鼓室给药技术在耳科疾病的临床应用越来越广泛,主要包括突发性聋、梅尼埃病、分泌性中耳炎和自身免疫性内耳病等疾病的诊治。目前,国内外对鼓室给药的操作规范、适应证,尤其是给药时机及治疗方案尚未有统一标准。为了促进鼓室给药技术规范化,我们特组织了国内在鼓室给药领域经验丰富,有卓越建树中青年专家,基于临床经验和循证医学证据制定了鼓室给药临床实践指南。本指南从鼓室给药操作规范出发,系统总结了糖皮质激素鼓室给药、庆大霉素鼓室给药、鼓室内注射造影剂膜迷路MRI成像及其他药物鼓室给药四个方面,旨在指导并规范临床鼓室给药技术的应用。Intratympanic drug delivery is a commonly used method for administering topical drugs in otology.It involves directly delivering drugs into the middle ear,allowing them to diffuse to the inner ear through the round window membrane or oval window.This method is employed to achieve therapeutic or diagnostic effects.In recent years,intratympanic drug delivery has become widely utilized in the diagnosis and treatment of various otological diseases including sudden sensorineural hearing loss,Meniere’s disease,secretory otitis media,and autoimmune inner ear diseases.However,there is currently no standardized protocol regarding the operation specifications,indications,timing of administration,and treatment plans for intratympanic drug delivery.In order to promote the standardization of intratympanic drug delivery,we have assembled a group of experienced and accomplished young and middle-aged domestic experts who possess extensive experience and notable achievements and formulated the clinical practice guidelines for intratympanic drug delivery based on clinical expertise and evidence-based medical researches.The guidelines primarily focus on four aspects of intratympanic drug delivery:glucocorticoids,gentamicin,intratympanic injection of contrast media,and other drugs.It provides a comprehensive and systematic summary of these aspects,with the goal of guiding and standardizing the clinical application of intratympanic drug delivery technology.

关 键 词：鼓室给药 糖皮质激素 庆大霉素 钆造影 临床实践指南 

分 类 号：R764[医药卫生—耳鼻咽喉科]