Abstract:

Objective   To observe the the short-term effectiveness of intratympanic dexamethasone(ITD) plus intravenous dexamethasone injection and conventional regimen for sudden sensorineural hearing loss(SSNHL).  Methods   The SSNHL cases were divided into treatment group A (11cases,11ears), treatment group B (11cases,13ears), control group A(11cases,11ears), and control group B(11cases,13ears) based on the admitted time. With informed consent signed, the patients in control group A and B were given intravenous injection of dexamethasone, highly oxygenized liquid(group A) or hyperbaric oxygen treatment (group B), accompanied by circulation booster/stasis elimination agents, vitamin and so on. Besides the above, ITD was performed in the treatment group A and B. Assessment of hearing function was carried out on the exact day or next day after one 10-day course. The results of pure tone average（PTA）were recorded and calculated at 500Hz, 1kHz, 2kHz, 4kHz, respectively. Meanwhile, the results at 250Hz and 8kHz were compared. Hearing improvement was defined as a 15 dB HL decrease. Results   The treatment group A showed an average increase of (25.73±6.07)dB HL(P<0.01). The treatment group B showed an average increase of (24.15±4.86)dB HL(P<0.01). The control group A showed average increase of (16.36±3.36) dB HL(P<0.01). The control group B showed an average increase of (19.46±6.01)dB HL(P<0.01). The PTA of four groups before and after the treatment all demonstrated statistical significance. Except for the treatment group A, the pure tone threshold at 250 Hz of all the three other groups before and after treatment showed statistical significance. Except for the treatment group B, the pure tone threshold at 8kHz of all the other three groups before and after treatment showed no statistical significance. No significant difference at 250 Hz was noted between the treatment group A and the control group B, while the same result was found at 8kHz between the treatment group A and control group B (P>0.01). Overall improvement was observed in 9 ears (81.8%) in the treatment group A and 4 ears (36.4%) in the control group A (P<0.05). Overall improvement were observed in 8 ears(61.5%) in the treatment group B and 5 ears(38.5%) in the control group B (P>0.05).There were no middle ear infection. The treatment was invalid for 1 case, but her hearing level stopped falling. In the process of injection, vertigo happened in 5 cases, temporary mild edema in 2 cases, while the rest 20 patients did not show any adverse reaction. Conclusion   Four kinds of treatments are effective for sudden sensorineural hearing loss. However, intratympanic joint intravenous dexamethasone plus conventional regimen is more effective, safer and simpler. Curative effect is better for low frequency than the high. Two treatment strategies have no obvious difference in the improvement of low frequency.

Key words: Intratympanic, Dexamethasone, Sudden sensorineural hearing loss