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目的:观察鼓室内注射地塞米松治疗突聋的临床效果。方法:对21例突聋患者采用鼓膜穿刺注入5 g/L地塞米松1 ml治疗,每日1次,7 d为1个疗程。比较地塞米松鼓室内注射前后4个频率(500、1 000、2 000、4 000 Hz)气导纯音听阈均值(PTA),下降10 dB以上为有效。结果:21例患者鼓室内注射地塞米松前后PTA分别为(65.65±24.73)dB HL和(50.25±25.59)dB HL,有明显下降,P<0.01。10例有效,11例无效,总有效率为47.6%。对发病至治疗的时间短、不伴眩晕的突聋患者应用鼓室内注射地塞米松治疗效果好。本组病例未出现鼓室内感染、鼓膜穿孔和听力下降。结论:鼓室内注射地塞米松治疗突聋安全、有效,发病至治疗的时间以及是否伴有眩晕是影响预后的因素。
Objective: To observe the clinical effect of intrathecal injection of dexamethasone in treating sudden deafness. Methods: Twenty-one patients with sudden deafness were treated with tympanic membrane infusion of 5 g / L dexamethasone 1 ml once daily and 7 days as a course of treatment. Before and after dexamethasone intragastric injection, four pilot frequencies (500, 1,000, 2,000 and 4,000 Hz) of air conduction pure tone hearing threshold (PTA) decreased more than 10 dB. Results: Before and after intrathecal injection of dexamethasone, the PTA of (65.65 ± 24.73) dB HL and (50.25 ± 25.59) dB HL were significantly decreased in 21 patients, P <0.01 was effective and 11 were ineffective. The total effective rate 47.6%. The incidence of treatment to a short period of time, without sudden dizziness in patients with deafness application of intrathecal injection of dexamethasone treatment effect. This group of patients did not appear typhoid infection, tympanic membrane perforation and hearing loss. Conclusion: It is safe and effective to treat deafness by intratympanic injection of dexamethasone in the treatment of sudden deafness, and the time from onset to treatment and the presence of dizziness are the prognostic factors.