Observation On The Efficacy Of The Combination Of Ultrasound-guided Stellate Ganglion Block And Pharmacological Treatment In Patients With Sudden Sensorineural Hearing Loss

Objective Sudden sensorineural hearing loss(SSNHL)is a sudden,unexplained unilateral or bilateral hearing loss.Hearing loss is the most common cause of disability in the world and the third leading cause of loss of productivity due to disability over the years.In modern society,SSNHL has become a serious social health problem.Although the direct mortality rate of this disease is very low,it has a great impact on the quality of life.How to implement the most effective and safe treatment for patients and minimize the occurrence of complications is particularly important.The purpose of this study was to assess the efficacy of the combination of ultrasound-guided stellate ganglion block(US-SGB)and pharmacological treatment in patients with sudden sensorineural hearing loss(SSNHL)and define patients amenable for US-SGB combined with pharmacological therapy.Methods A total of 50 inpatients with SSNHL were collected from the Department of Otorhinolaryngology,Chaohu Hospital affiliated to Anhui Medical University from May 2019 to February 2020,including 28 males and 22 females,aged > 18 years,with a course of disease ≤ 14 days.All of them met the diagnostic criteria of SSNHL in the diagnosis and treatment guidelines of Otorhinolaryngology head and neck surgery Branch of Chinese Medical Association.The patients were randomly divided into pharmacological treatment(P)group and US-SGB+ pharmacological treatment(US-SGB+P)group.P group was treated with routine oral pharmacological therapy for10 days,and US-SGB+P group was treated with US-SGB for 10 days in addition to the same pharmacological treatment as P group.The average pure tone hearing threshold(PTA)of the two groups was recorded before treatment,10 days after treatment and 6months after treatment.Peripheral venous blood samples were taken before treatment and 6 months after treatment to monitor the changes of neutrophil count,lymphocyte count and neutrophil-to-lymphocyte ratio(NLR).The average pure tone hearing threshold,clinical efficacy and prognosis of the two groups before and after treatment were compared,and the patients who could benefit from US-SGB treatment were identified.Results After treatment,the hearing of the two groups were improved,and the difference was statistically significant(P < 0.05).The total effective rate of US-SGB +P group was higher than that of P group,and the difference was statistically significant(P < 0.05).After 6 months of treatment,the neutrophil count,lymphocyte count and neutrophil-to-lymphocyte ratio(NLR)of the two groups were improved,and the difference was statistically significant(P<0.05)There was statistical significance(P<0.05),but the prognosis of US-SGB + P group was better than that of P group,the difference was statistically significant(P<0.05).In addition,the effective rate of US-SGB + P group for patients with mild to moderate hearing loss,age ≤ 50 years old or without dizziness / vertigo was higher than that of patients with severe hearing loss,age > 50 years old or with dizziness / vertigo,the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided stellate ganglion block combined with pharmacological treatment has better curative effect on hearing recovery than pharmacological therapy alone,and the prognosis is faster,and it is more amenable for patients with moderate hearing loss,age ≤ 50 years or without dizziness / vertigo.