Perfusion Steroid via Ventilation Tube as Salvage Treatments for Sudden Sensorineural Hearing Loss.

Yang Mingbao, Zhang Bei, Guan Yafeng, Liang Xiuni, Miao Beiping
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Abstract

Objectives: Intratympanic steroid injection (ISI) for sudden sensorineural hearing loss (SSNHL) is a relatively popular and effective method, but there is no standardized method for intratympanic steroids for the treatment of SSNHL and no consensus on how to deliver steroids to the middle ear. The purpose of this study was to compare 2 means of intratympanic steroid delivery as therapy for SSNHL. Methods: A retrospective chart review was performed for the period from November 2018 to October 2022 at our Department of Otorhinolaryngology-Head and Neck Surgery. Sixty patients with profound SSNHL who have failed initial steroid therapy were divided into the continuously transtympanic steroid perfusion (TSP) therapy and the intermittent ISI therapy. Results: Posttreatment pure-tone average was 60.3 ± 18.2 dB in the TSP group and 67.5 ± 22.6 dB in the ISI group, 70.0% of subjects in the TSP group, and 46.7% of subjects in the ISI group had improved by 15 dB or more after the therapy. The increased hearing threshold of the TSP group (24.6 ± 14.1 dB) was better than the ISI group (16.6 ± 14.9 dB), and the hearing recovery was significantly different (P < .05) in the 2 groups. Besides the hearing improvement was most obvious in low-frequency areas in the TSP group, the most significant hearing improvement was at 250 Hz, reaching 30.8 ± 3.3 dB. Conclusions: In SSNHL patients who have failed initial steroid therapy, TSP therapy via a ventilation tube can achieve good hearing outcomes and serve as a salvage therapy for patients with SSNHL.

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通过通气管灌注类固醇作为突发性感音神经性听力损失的挽救性治疗。
目的:鼓室内类固醇注射(ISI)治疗突发性感音神经性听力损失(SSNHL)是一种相对流行且有效的方法,但目前还没有治疗 SSNHL 的鼓室内类固醇标准方法,也没有就如何将类固醇输送到中耳达成共识。本研究的目的是比较治疗 SSNHL 的两种鼓室内类固醇给药方法。方法:本院耳鼻咽喉头颈外科对 2018 年 11 月至 2022 年 10 月期间的病历进行了回顾性分析。60例初始类固醇治疗失败的重度SSNHL患者被分为连续经鼓室类固醇灌注(TSP)疗法和间歇性ISI疗法。结果显示TSP组治疗后纯音平均值为(60.3 ± 18.2)分贝,ISI组为(67.5 ± 22.6)分贝,TSP组70.0%的受试者和ISI组46.7%的受试者在治疗后听力提高了15分贝或更多。TSP 组的听阈提高幅度(24.6 ± 14.1 dB)优于 ISI 组(16.6 ± 14.9 dB),两组的听力恢复情况有显著差异(P < .05)。此外,TSP 组的听力改善在低频区域最为明显,听力改善最显著的是 250 Hz,达到 30.8 ± 3.3 dB。结论对于初始类固醇治疗失败的 SSNHL 患者,通过通气管进行 TSP 治疗可获得良好的听力效果,可作为 SSNHL 患者的挽救疗法。
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