Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2024, Vol. 38 ›› Issue (4): 15-21.doi: 10.6040/j.issn.1673-3770.0.2023.083

• Original Article • Previous Articles    

Comparative analysis of speech recognition ability before and after treatment of intractable sudden deafness using retroaural injection of ganglioside and intratympanic injection of methylprednisolone

CAO Ying1, QIU Yue1, CHEN Zhibin2, FEI Bing1, LI Dong1, ZHANG Xiaofeng3,WANG Hui4,KANG Xinle5, WANG Haixu1,HUAI De1,LI Xiuting6, SHU Mingyang7   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, Huai'an Second People's Hospital, Huai'an 223002, Jiangsu, China2. Department of Otorhinolaryngology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China3. Department of Pharmacy, Huai'an Second People's Hospital, Huai'an 223002, Jiangsu, China4. Department of Nursing, Huai'an Second People's Hospital, Huai'an 223002, Jiangsu, China5. Department of Ophthalmology, Huai'an Second People's hospital, Huai'an 223002, Jiangsu, China6. Jiangsu Health Vocational College, School of Public Health Administration, Nanjing 210000, Jiangsu, China7. Department of Stomatology, Huai'an Second People's hospital, Huai'an 223002, Jiangsu, China
  • Published:2024-07-09

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Abstract: Objective This study aimed to analyze the impact of postauricular injection of ganglioside combined with intratympanic injection of methylprednisolone on word recognition score(WRS)and its influencing factors in patients with unilateral refractory sudden deafness. Methods This study included 58 patients with refractory sudden deafness who were treated with postauricular ganglioside injection combined with intratympanic methylprednisolone injection. Data was collected on the patients' age, sex, disease duration, ear category, concomitant symptoms, and pure tone audiometry(PTA)and speech audiometry results pre- and post-treatment. The PTA results and the maximum speech recognition rate(WRSmax)were statistically analyzed pre- and post-treatment. Logistic regression analysis was applied to identify factors that improve WRS. Results Patients with refractory sudden deafness showed significant improvements in PTA and WRS in the affected ear after treatment(P=0.027,P=0.038). Furthermore, a negative correlation was observed between PTA and WRS(r=-0.682, P<0.05). Univariate analysis revealed that age, sex, precipitating factors, affected ear, concomitant symptoms, and WRS were not significantly correlated(P=0.693, P=0.208,P=0.079, P=0.335, P=0.331)), and the differences were not statistically significant. However, time from onset to the first visit, degree of hearing damage, and type of hearing curve were identified as important factors that influenced improvement in WRS(P=0.010, P=0.033, P=0.026). Conclusion Administration of postauricular ganglioside combined with intratympanic methylprednisolone resulted in a 41.38% improvement in WRS for patients with refractory sudden deafness. Improvement in WRS was also influenced by the time from onset to the first visit, degree of hearing impairment, and type of hearing curve. The improvement in WRS was significantly worse in those with a longer time from onset to first visit than in those with a shorter duration; however, it was significantly better in those with low-frequency hearing loss than in those with flat and high-frequency hearing loss after treatment with the aforementioned methods. The severity of hearing impairment negatively impacted improvement in WRS.

Key words: Refractory idiopathic sudden sensorineural hearing loss, Intratympanic and postauricular injection, Word recognition score, Pure-tone average

CLC Number: 

  • R764.5
[1] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 突发性聋诊断和治疗指南(2015)[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(6): 443-447. doi:10.3760/cma.j.issn.1673-0860.2015.06.002
[2] Klemm E, Deutscher A, Mösges R. A present investigation of the epidemiology in idiopathic sudden sensorineural hearing loss[J]. Laryngo Rhino Otol, 2009, 88(8): 524-7. doi: 10.1055/s-0028-1128133
[3] 钟晓声, 杨海弟, 郑亿庆. 突发性聋伴耳鸣的治疗与转归[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 43-46. doi: 10.6040/j.issn.1673-3770.0.2018.393 ZHONG Xiaosheng, YANG Haidi, ZHENG Yiqing. Treatment and outcome of tinnitus in sudden deafness[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 43-46. doi: 10.6040/j.issn.1673-3770.0.2018.393
[4] 钟丽萍, 官希龙, 王晶晶, 等. 鼓室与全身应用激素治疗突发性耳聋的系统评价与Meta分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 1-10. doi:10.6040/j.issn.1673-3770.0.2021.010 ZHONG Liping, GUAN Xilong, WANG Jingjing, et al. Intratympanic injections and systemic glucocorticoid treatment for sudden hearing loss: a systematic review and Meta-analysis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 1-10. doi:10.6040/j.issn.1673-3770.0.2021.010
[5] Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical practice guideline: sudden hearing loss(update)executive summary[J]. Otolaryngol Head Neck Surg, 2019, 161(2): 195-210. doi:10.1177/0194599819859883
[6] 梁思玉, 郑芸, 李刚. 言语识别率对突聋疗效评估的意义[J]. 听力学及言语疾病杂志, 2015, 23(1): 32-34. doi:10.3969/j.issn.1006-7299.2015.01.008 LIANG Siyu, ZHENG Yun, LI Gang. A preliminary study of the clinical significance of word recognition scores in evaluating the curative effects of sudden hearing loss[J]. Journal of Audiology and Speech Pathology, 2015, 23(1): 32-34. doi:10.3969/j.issn.1006-7299.2015.01.008
[7] 韩东一,翟所强,韩维举.临床听力学[M]. 北京: 中国协和医科大学出版社, 2008: 183, 198, 185~187
[8] Haynes DS, O'Malley M, Cohen S, et al. Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy[J]. Laryngoscope, 2007, 117(1): 3-15. doi:10.1097/01.mlg.0000245058.11866.15
[9] 石安妮, 张佳佳, 白鹏, 等. 浅析 “颈部七线法” 针刺治疗突发性耳聋的内涵[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 103-107. doi:10.6040/j.issn.1673-3770.0.2021.412 SHI Anni, ZHANG Jiajia, BAI Peng, et al. Analysis of a therapeutic modality for sudden deafness utilizing neck acupuncture comprising seven lines of treatment[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 103-107. doi:10.6040/j.issn.1673-3770.0.2021.412
[10] 段新艳, 宋忠义, 王宁, 等. DPOAE与高刺激率ABR在听力正常耳鸣患者中的应用价值[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 6-10. doi:10.6040/j.issn.1673-3770.0.2021.404 DUAN Xinyan, SONG Zhongyi, WANG Ning, et al. Application value of distortion product otoacoustic emission and high stimulation rate auditory brainstem response in patients with normal hearing tinnitus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 6-10. doi:10.6040/j.issn.1673-3770.0.2021.404
[11] Kim YH, Park KT, Choi BY, et al. Early combination treatment with intratympanic steroid injection in severe to profound sudden sensorineural hearing loss improves speech discrimination performance[J]. Eur Arch Oto Rhino Laryngol, 2012, 269(10): 2173-2178. doi:10.1007/s00405-011-1874-6
[12] 乔宇斐, 郝文洋, 商莹莹, 等. 单侧耳聋病程对声源定位及噪声下言语识别的影响[J]. 听力学及言语疾病杂志, 2019, 27(2): 134-139. doi:10.3969/j.issn.1006-7299.2019.02.006 QIAO Yufei, HAO Wenyang, SHANG Yingying, et al. Effects of the duration and onset age of single sided deafness on sound localization and speech recognition in noise[J]. Journal of Audiology and Speech Pathology, 2019, 27(2): 134-139. doi:10.3969/j.issn.1006-7299.2019.02.006
[13] 孙进, 朱笛, 王璐, 等. 助听器对单侧听力损失患者噪声环境中言语识别的补偿效果[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(8): 571-575. doi:10.13201/j.issn.2096-7993.2022.08.001 SUN Jin, ZHU Di, WANG Lu, et al. Compensation effect of hearing aid on speech recognition in noise in patients with unilateral hearing loss[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2022, 36(8): 571-575. doi:10.13201/j.issn.2096-7993.2022.08.001
[14] 韩东一, 杨伟炎. 普及言语测听提高耳科学诊疗水平[J]. 中华耳科学杂志, 2008, 6(1): 7-8. doi:10.3969/j.issn.1672-2922.2008.01.002 HAN Dongyi, YANG Weiyan. Popularizing speech audiometry and improving the level of otology diagnosis and treatment[J]. Chinese Journal of Otology, 2008, 6(1): 7-8. doi:10.3969/j.issn.1672-2922.2008.01.002
[15] 侯志强, 兰兰, 王大勇, 等. 老年突发性耳聋的临床特征和转归[J]. 中华耳科学杂志, 2010, 8(2): 141-147. doi:10.3969/j.issn.1672-2922.2010.02.006 HOU Zhiqiang, LAN Lan, WANG Dayong, et al. The clinical features and prognosis of sudden deafness in the elderly[J]. Chinese Journal of Otology, 2010, 8(2): 141-147. doi:10.3969/j.issn.1672-2922.2010.02.006
[16] Pensak ML, Glasscock ME III, Josey AF, et al. Sudden hearing loss and cerebellopontine angle tumors[J]. Laryngoscope, 1985, 95(10): 1188, 1193. doi:10.1288/00005537-198510000-00007
[17] 孙渊渊, 郭洋, 夏俍, 等. 影响突发性聋患者言语识别率恢复的因素的研究进展[J]. 中华耳科学杂志, 2017, 15(6): 727-731. doi:10.3969/j.issn.1672-2922.2017.06.023 SUN Yuanyuan, GUO Yang, XIA Liang, et al. Research progress on influencing factors of the recovering of speech recognition rate in sudden sensorineural hearing loss[J]. Chinese Journal of Otology, 2017, 15(6): 727-731. doi:10.3969/j.issn.1672-2922.2017.06.023
[18] 陈琪, 郑海峰, 谌国会, 等. 单侧突发性耳聋治疗前后言语识别能力对比分析[J]. 中华耳科学杂志, 2021, 19(5): 787-792. doi: 10.3969/j.issn.1672-2922.2021.05.011 CHEN Qi, ZHENG Haifeng, CHEN Guohui, et al. analysis of word recognition score after treatment of idiopathic sudden sensorineural hearing loss[J]. Chinese Journal of Otology, 2021, 19(5): 787-792. doi: 10.3969/j.issn.1672-2922.2021.05.011
[19] Choo OS, Yang SM, Park HY, et al. Differences in clinical characteristics and prognosis of sudden low- and high-frequency hearing loss[J]. Laryngoscope, 2017, 127(8): 1878-1884. doi:10.1002/lary.26382
[20] 司建平, 姜子刚, 杨丽莉, 等. 全频下降型突发性聋患者听力初始恢复频率与预后相关性研究[J]. 中国耳鼻咽喉头颈外科, 2017, 24(10): 547-548. doi:10.16066/j.1672-7002.2017.10.015 SI Jianping, JIANG Zigang, YANG Lili, et al. Correlation between initial recovery frequency of hearing and prognosis in patients with full-frequency descending sudden deafness[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2017, 24(10): 547-548. doi:10.16066/j.1672-7002.2017.10.015
[21] Bae SC, Noh HI, Jun BC, et al. Efficacy of intratympanic steroid therapy for idiopathic sudden sensorineural hearing loss: comparison with systemic steroid therapy and combined therapy[J]. Acta Oto Laryngol, 2013, 133(5): 428-433. doi:10.3109/00016489.2012.749520
[22] 吴悔, 梁敏, 陈建勇, 等. 全聋型突发性耳聋患者的预后与前庭症状及前庭功能关系的回顾性分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 33-38. doi: 10.6040/j.issn.1673-3770.1.2020.075 WU Hui, LIANG Min, CHEN Jianyong, et al. Relationship between prognosis and vestibular symptoms/function in patients with unilateral profound sudden sensorineural hearing loss: a retrospective analysis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 33-38. doi: 10.6040/j.issn.1673-3770.1.2020.075
[23] 李国庆, 吕萍, 王秋菊. 隐性听力损失的发病机制及听力学表现[J]. 中华耳科学杂志, 2017, 15(2): 185-190. doi:10.3969/j.issn.1672-2922.2017.02.009 LI Guoqing, LV Ping, WANG Qiuju. Pathogenesis and audiologic performances in hidden hearing loss[J]. Chinese Journal of Otology, 2017, 15(2): 185-190. doi:10.3969/j.issn.1672-2922.2017.02.009
[24] 张静平, 王巍, 王悦, 等. 语后聋成人人工耳蜗植入患者术后生活质量和言语识别能力评估[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(11): 1002-1004. doi:10.13201/j.issn.2096-7993.2020.11.010 ZHANG Jingping, WANG Wei, WANG Yue, et al. Assessment of speech perception and quality of life after cochlear implant in postlingual deaf adults[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(11): 1002-1004. doi:10.13201/j.issn.2096-7993.2020.11.010
[25] 郗昕. 成人言语测听的基本内容及其临床价值[J]. 临床耳鼻咽喉头颈外科杂志, 2013, 27(7): 337-339. doi:10.13201/j.issn.1001-1781.2013.07.004 XI Xin. The basic content and clinical value of adult speech audiometry[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2013, 27(7): 337-339. doi:10.13201/j.issn.1001-1781.2013.07.004
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