前期治疗对地塞米松鼓室注射治疗难治性突发性聋的影响

目的观察强的松、舒血宁治疗没有痊愈的突发性聋患者应用地塞米松鼓室内注射后的疗效，以及其疗效是否与前期的不同治疗有关。方法2005年9月-2007年11月门诊突发性聋患者53例（53耳），分成2组：第一组为激素治疗组（27耳），第二组为舒血宁治疗组（26耳）。上述治疗后没有痊愈的患者共34耳，给予地塞米松2mg鼓室内注射，一周内注射2次。结果激素治疗组19耳有效（70．4％），舒血宁治疗组17耳有效（65.4％），经检验两组疗效没有显著性差异。地塞米松鼓室内注射总有效率38．2％，其中前期激素组7耳有效（41．2％），前期舒血宁治疗组6耳（35.3％）有效，经检验两组疗效没有显著性差异。结论鼓室内注射地塞米松可以对前期治疗没有痊愈的突发性聋患者有效，疗效与之前是否用激素无关。

Influence of interventions prior to introtympanic dexamethesone injection on treatment outcomes in sudden deafness

Objective To investigate the efficacy of dexamethasone intratympanic injection for sudden sensorineu-ral hearing loss when administered after steroid or Shuxuening(Ginko biloba) treatments. Methods Fifty-three cases (53 ears) of sudden sensorineural hearing loss (SSHL) were treated with either prednisone (30 mg/d for 5 days followed by 5 days of tapering) or with intravenous Shuxuening (20 ml/d for 10 days). Following prednisone and Shuxuening treatments, 34 patients went on to receive intratympanic dexamethasone injection (ITDI) twice a week. Results Hearing improved in 19 of the 27 patients (70.4%) who were treated with oral prednisone and in 17 of the 26 patients (65.4%) treated with intravenous shuxuening. The difference was not statistically significant between the two groups. Of the 34 patients who received ITDI in addition to prednisone (n=17) or Shuxuening (n=17) treatments, 13 (38.2%) showed hearing improvement compared to before ITDI. ITDI-related hearing improvement was seen in 7 of the 17 patients (41.2%) who received prednisone prior to ITDI and in 6 of the 17 patients (35.3%) who received shuxuening prior to ITDI. The difference was again statistically insignificant. Conclusion ITDI appears to provide additional treatment benefits for patients with SSHL who have been treated with oral prednisone or Shuxuening. The outcome is not affected by pretreatment with prednisone.