摘要
目的:探讨在全聋伴持续耳鸣的突发性耳聋患者中,早期鼓室注射地塞米松不同给药频次(每日与隔日)对听力恢复及耳鸣改善的影响,旨在优化治疗方案,提升临床干预效果。方法:纳入2022年1月至2025年3月南京医科大学第三附属医院耳鼻喉科收治的60例全聋伴持续耳鸣的突发性耳聋患者,随机分为观察组(每日鼓室注射地塞米松,n=30)和对照组(隔日鼓室注射地塞米松,n=30),比较两组不良反应发生情况、听力改善情况及临床疗效。结果:治疗期间,两组均未出现注射相关不良反应,如眩晕、恶心、鼓膜穿孔或中耳感染等,亦未出现听力进一步下降或耳鸣加重的情况,安全性良好。治疗后,在纯音测听分析中,两组在各频段(0.5、1、2、4、8 kHz)均显示出听阈的下降,观察组在高频段(2~8 kHz)的改善幅度更为显著。观察组耳鸣改善总有效率83.3%,显著高于对照组的66.7%(P<0.05)。结论:全身治疗结合早期每日鼓室注射地塞米松较隔日注射在促进全聋伴持续耳鸣的突发性耳聋患者听力恢复方面疗效更优,特别是在高频听力改善方面具有明显优势,对耳鸣缓解亦有一定促进作用,且安全性高,值得临床进一步推广应用。
Objective:To investigate the effects of different administration frequencies(daily vs.every other day)of early intratympanic dexamethasone injection on hearing recovery and tinnitus improvement in patients with total deafness and persistent tinnitus due to sudden sensorineural hearing loss(SSNHL),aiming to optimize the treatment regimen and enhance clinical outcomes.Methods:A total of 60 patients with total deafness and persistent tinnitus due to SSNHL,admitted to the Department of Otolaryngology at The Third Affiliated Hospital of Nanjing Medical University between January 2022 and March 2025,were enrolled and randomly assigned to an observation group(daily intratympanic dexamethasone injection,n=30)and a control group(every-other-day intratympanic dexamethasone injection,n=30).The incidence of adverse reactions,hearing improvement,and clinical efficacy were compared between the two groups.Results:During the treatment period,neither group experienced injection-related adverse reactions such as dizziness,nausea,tympanic membrane perforation,or middle ear infection,nor further hearing loss or worsening of tinnitus,indicating good safety.After treatment,pure-tone audiometry analysis showed a decrease in hearing thresholds across all frequencies(0.5,1,2,4,8 kHz)in both groups,with the observation group demonstrating more significant improvement in the high-frequency range(2–8 kHz).The total effective rate for tinnitus improvement was 83.3%in the observation group,significantly higher than the 66.7%in the control group(P<0.05).Conclusion:Systemic therapy combined with early daily intratympanic dexamethasone injection is more effective than every-other-day injection in promoting hearing recovery in patients with total deafness and persistent tinnitus due to SSNHL,particularly showing significant advantages in high-frequency hearing improvement.It also contributes to tinnitus relief with high safety,making it worthy of further clinical application.
作者
徐莹
顾晓峰
肖锋
陆文敏
李霞
XU Ying;GU Xiaofeng;XIAO Feng;LU Wenmin;LI Xia(Department of Otolaryngology,The Third Affiliated Hospital of Nanjing Medical University/Changzhou Second People's Hospital,Changzhou 213000,China)
出处
《延边大学医学学报》
2025年第10期67-71,共5页
Journal of Medical Science Yanbian University
关键词
突发性耳聋
全聋
持续耳鸣
鼓室注射
地塞米松
注射频次
Sudden sensorineural hearing loss
Total deafness
Persistent tinnitus
Intratympanic injection
Dexamethasone
Injection frequency
