[Topical injection and systemic application of glucocorticoids in the treatment of idiopathic sudden sensorineural hearing loss by type].

Abstract

OBJECTIVE:

To investigate the therapeutic effect of topical corticosteroids injection and systemic application in the treatment of typing idiopathic sudden sensorineural hearing loss (ISSNHL).

METHODS:

Total of 438 patients with ISSNHL, including 76 with hearing loss in low-middle frequencies, 43 in middle-high frequencies, 162 in all frequencies and 157 in total deafness, were randomly divided into two groups, the systemic application group: dexamethasone (DEX) was applied by intravenous injection in dose of 10 mg×3 d followed by 5 mg×4 d, and the topical injection group: methylprednisolone sodium succinate of 40 mg was injected into cortical bone of mastoid region every three days. According to the results of pure-tone threshold audiometry, the curative effect among ISSNHL with low-middle frequencies, middle-high frequencies, all frequencies hearing loss, and total deafness were evaluated. SPSS 18.0 software was used to analyze the data.

RESULTS:

Among 220 patients with systemic application of DEX, 66 subjects (30.0%) cases were recovery, 51 (23.2%) were excellent better, 39 (17.7%) better, 64 (29.1%) were poor, and the total effective rate was 70.9% (156/220) . There was no statistical difference in total effective rate of four typing subgroups (χ(2) = 1.60, P > 0.05). And the recovery rate in total deafness subgroup was significant lower than that in low-middle and all frequencies subgroups (χ(2) = 10.63 and 15.94 respectively, both P < 0.05). In the topical injection group, the recovery rate was 30.3% (66 cases), excellent better 18.8% (41), better 15.6% (34), poor 35.3% (77), and the total effective rate was 64.7% (141/220) . There were statistical differences of total effective rate in low-middle frequencies in comparison with that in all frequencies (χ(2) = 8.38) and total deafness (χ(2) = 7.28) subgroups (both P < 0.05). Regarding recovery rate, there were significant differences between each two typing subgroups, except middle-high frequencies subgroup vs. all frequencies (χ(2) = 1.60) and total deafness (χ(2) = 2.29) subgroups (both P < 0.05). In 76 ISSNHL with hearing loss in low-middle frequencies, the recovery rate in cases with local corticosteroids injection(65.0%) was significantly increased in comparison with that with systemic application (41.7%), χ(2) = 4.15, P < 0.05. There were increasing tendencies of curative effect in other three typing groups by systemic corticosteroids application when compared with local injection, but no statistical significances (all P > 0.05).

CONCLUSIONS:

For low-middle frequencies ISSNHL, the corticosteroids administration of local injection should be the optimization. Systemic application would be applied for middle-high frequencies, all frequencies and total deafness.

• Authors: Mingming Wang, Zhaomin Fan, Zhiqiang Hou, Daogong Zhang, Haibo Wang
• Journal: Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery (Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi) Vol. 49 Issue 1 Pg. 11-5 (Jan 2014) ISSN: 1673-0860 [Print] China
• PMID: 24680330 (Publication Type: English Abstract, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Glucocorticoids

Topics

• Adult
• Aged
• Female
• Glucocorticoids (administration & dosage, therapeutic use)
• Hearing Loss, Sudden (drug therapy)
• Humans
• Injections
• Male
• Middle Aged
• Treatment Outcome