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目的:观察圆窗内置管微泵灌注地塞米松治疗难治性突发性感音神经性聋(突聋)的疗效。方法:13例常规方法治疗4.8周无效的突聋患者,作外耳道皮瓣,圆窗置管经微泵灌注地塞米松,每次2.5mg,维持1h,每天2次,连续给药1周。用药期间观察记录听力改变、耳鸣和眩晕等情况。结果:13例患者治疗完成后1个月纯音测听检查:显效2例,0.25~4.00kHz听阈平均提高30.5dB;有效3例,平均提高16.7dB;无效8例,有效率38.5%(5/13)。结论:圆窗置管微泵灌注地塞米松治疗突聋的方法,能保证药物持续泵入和高浓度作用于内耳,优于鼓膜穿刺注药;操作稍复杂,但创伤小,耗费不高,为常规方法治疗无效的突聋患者提供了再次治疗获效的机会。
Objective: To observe the curative effect of refractory sudden sensorineural deafness (sudden deafness) treated by intraductal injection of dexamethasone in a circular window. Methods: Thirteen patients with sudden deafness who were inactive for 4.8 weeks were treated with conventional method for deafness-induced deafness in rabbits of 4.8 weeks. Dexamethasone was infused into the round window through a micro-pump. Each dexamethasone was infused 2.5mg once for 2 hours a day for 1 week. Observed during treatment recorded changes in hearing, tinnitus and dizziness and so on. Results: The results of pure tone audiometry examination in one month after the completion of treatment in 13 patients were as follows: 2 cases markedly improved, 30.5 dB hearing threshold increased from 0.25 to 4.00 kHz on average, 3 cases were effective and 16.7 dB increased on average, 8 cases were ineffective, and the effective rate was 38.5% 13). CONCLUSION: The method of round window micropump with infusion of dexamethasone for treatment of sudden deafness can ensure continuous pump-in and high concentration of drug in the inner ear, which is better than tympanic membrane injection. The operation is slightly complicated, but the trauma is small and the cost is not high. For the conventional method of treatment of patients with sudden deafness provides the opportunity to re-treatment and efficacy.