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目的:观察鼓室内地塞米松注射(IDI)治疗难治性突发性感音神经性聋(突聋)的疗效。方法:25例常规方法治疗无效的突聋患者采用IDI,首次剂量为2.5mg,此后,每2天重复注药1次(每次2.5mg),共4次,总剂量10mg。用药期间密切观察记录听力改变、耳鸣和眩晕等情况。结果:2例失访,23例治疗完成后1个月纯音测听检查:显效3例,0.25～4.00kHz听阈平均提高48.5dB;有效5例,平均提高18.5dB;无效15例;有效率为34.8%(8/23)。结论:IDI治疗突聋,能保证药物高浓度作用于内耳,避免全身用药可能产生的不良反应;治疗操作不复杂,创伤性小,为常规方法治疗无效的突聋患者提供了再次治疗的机会。
Objective: To observe the effect of intrathecal dexamethasone injection (IDI) in the treatment of refractory sudden sensorineural deafness (sudden deafness). Methods: IDI was used in 25 patients with sudden deafness who were ineffective in conventional treatment. The first dose was 2.5 mg. After that, the medicine was injected once every two days (2.5 mg each time) for a total of 4 times with a total dose of 10 mg. Close observation during the recording of hearing changes, tinnitus and dizziness and so on. Results: Two patients were lost to follow-up. One month after the completion of treatment, pure tone audiometry was performed in 3 patients. The hearing threshold was increased by 48.5dB on average from 0.25 to 4.00kHz. Five patients were effective, with an average increase of 18.5dB. The effective rate was 34.8% (8/23). Conclusion: IDI treatment of sudden deafness can ensure the high concentration of drug acting on the inner ear and avoid the possible adverse reactions of systemic medication. The treatment is uncomplicated and traumatic, which offers opportunities for re-treatment for patients with sudden deafness who are ineffective in conventional treatment.