鼓室置管灌注甲泼尼龙治疗突发性聋的听力疗效分析

Efficacy of Intratympanic Methylprednisolone Perfusion for the Treatment of Sudden Sensorineural Hearing Loss

戴艳红;后婕;陆玲;杨霞;李惠;杨烨;佘万东;

1:南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科

2:南京大学医学院

摘要
目的观察鼓室置管灌注甲泼尼龙治疗突发性聋的听力疗效。方法回顾性分析2008年1月至2012年12月因常规治疗疗效欠佳行鼓室置管灌注甲泼尼龙的87例(87耳)突发性聋患者的听力疗效,均为单耳发病,其中全聋型67例,平坦型16例,低中频下降型2例,中高频下降型2例。发病至鼓室灌注的时间≤15天(A组)、1630天(B组)和≥31天(C组)组分别为33、33和21例。结果 87例中总有效率为34.48%(30/87),A、B、C三组有效率分别66.67%(22/33),21.21%(7/33)和4.76%(1/21);三组平均PTA改善分别为18.53±13.54、5.92±15.18和3.69±7.00dB,A组疗效优于B组和C组(P<0.01)。不同听阈曲线类型突聋患者的有效率和PTA改善值之间差异无统计学意义,有效的30例中,1例为低中频下降型,其余29例均为全频听力下降(全聋型或平坦型),灌注前后0.25、0.5、1、2、4和8kHz平均听阈改善分别为35.17±18.15、35.38±15.90、31.28±19.74、21.31±17.34、14.97±16.00和13.80±16.35dB,低中频(0.25、0.5和1kHz)的听阈改善程度优于中高频(2、4和8kHz)(P<0.01)。结论常规治疗疗效不佳的突发性聋患者,尽早鼓室置管灌注甲泼尼龙可能会获得更好的听力恢复,且低中频的听力恢复效果优于中高频。
关键词
突发性聋;鼓室灌注;甲泼尼龙;听力改善
基金项目(Foundation):
国家自然科学基金项目(81271074);; 第十批江苏省“六大人才高峰”项目(2013年);; 南京市国际联合研究项目(2012sd311038);; 南京市医学科技发展项目(YKK13054);; 中央高校苗圃项目(021414340101)联合资助
作者
戴艳红;后婕;陆玲;杨霞;李惠;杨烨;佘万东;
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