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《Journal of Clinical Otorhinolaryngology Head and Neck Surgery》 2010-13
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The effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss

YANG Jun1 HUANG Li1 SHI Jun1 LI Yun1 WU Hao1 KONG Weijia2(1Department of Otorhinolaryngology-Head and Neck Surgery,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai Jiaotong University School of Medicine Ear Institute,Shanghai,200092,China;2Department of Otorhinolaryngology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology)  
Objective:To investigate the effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss.Method:Forty-seven subjects received an at least 7-day dexamethasone(5 g/L/d) or methylprednisolone(40 g/L/d) course.Pure-tone averages(PTA) of pre-injection and post-injection at 4-frequency(500、1000、2000、4000 Hz) were compared.More than 10 dB HL of improvement in PTA was considered to be clinically significant.Result:PTA of pre-injection and post-injection were(71.59±27.66)dB HL and(53.44±30.10)dB HL respectively in 24 patients with intratympanic dexamethasone.There was significant improvement in PTA(P0.01),1.67% of patients showed improvement in hearing.PTA of pre-injection and post-injection were(68.64±25.21)dB HL and(55.76±26.42)dB HL respectively in 23 patients with intratympanic methylprednisolone.There was significant improvement in PTA(P0.01),43% of patients showed improvement in hearing.There was no significant difference in PTA between intratympanic dexamethasone and methylprednisolone.After dexamethasone injection,evident improvement was accomplished in 11 cases who underwent treatment with other therapy(systemic steroids,vasodilator agent,or high-pressure-oxygen therapy)(P0.05);PTA showed significant improvement in 13 cases with only intratympanic dexamethasone(P0.05).After methylprednisolone injection,evident improvement was accomplished in 17 cases who underwent treatment with other therapy(P0.01);PTA decreased but had no significance in 6 cases with only intratympanic methyl-prednisolone(P0.05).No unexpected adverse events such as otitis media,perforated tympanic membrane and worsening in hearing occurred during the injection or follow-up period.Conclusion:Intratympanic dexamethasone or methylprednisolone can be beneficial in treatment on patient with sudden sensorineural hearing loss,however,there was no significant difference in the effect between dexamethasone and methylprednisolone.Dexamethasone is recommended to use as favorable drug for intratympanic application that could be primary therapy in treatment on sudden sensorineural hearing loss.
【Fund】: 上海市科委资助课题(No:034119819);; “十一五”国家科技支撑计划-前庭中枢代偿机制及眩晕疾病规范化诊断与康复治疗方案研究(No:2007BAI18B13)
【CateGory Index】: R764.43
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