Therapeutic Effect Of Intratympanic Dexamethasone–Hyaluronic Acid Gel On Severe-to-Profound Sudden Sensorineural Hearing Loss

Objective:To investigate the Therapeutic effect of Intra Tympanic Dexamethasone–Hyaluronic Acid gel on severe-to-profound Sudden Sensorineural Hearing Loss.Methods:Forty-eight patients with severe-to-profound sudden sensorineural hearing loss who visited the Otorhinolaryngology–Head and Neck Surgery,First Affiliated Hospital of Nanchang Nanchang University from August 2022 to February 2023 were selected and were divided into the control group and the experimental group according to the random number table.The control group received systemic treatment combined with tympanic injection of dexamethasone,and the experimental group received systemic treatment combined with tympanic injection of dexamethasone–hyaluronic acid gel.Pure tone threshold tests were tested before the treatment and 2 months after treatment to compare the efficacy of the two groups.Results:By comparing the audible threshold before and after treatment we found that of the 24 patients in the control group,13 patients were ineffective,4 patients were effective,6 patients were significantly effective,and 1 patients was cured,with an overall response rate of 45.8%.for the 24 patients in experimental group,12 patients were ineffective,5 patients were effective,5 patients were significantly effective,2patients were recovery,the overall response rate of 50%,the difference in response rate between the two groups was not statistically significant(P > 0.05).In the control group,the mean hearing threshold was 86.61 ± 18.06 d B before treatment,and 74.79± 26.58 d B after treatment,and the hearing improvement value at the damaged frequency was 10.30 ± 20.51 d B.In the experimental group,the mean hearing threshold was 90.68 ± 17.44 d B before treatment and 71.15 ± 26.71 d B after treatment,and the hearing improvement value at the impaired frequency was 18.54 ±17.91 d B.The hearing improvement value of the experimental group was higher than that of the control group after treatment,but it was not statistically significant(P >0.05).Comparing the hearing improvement values at each frequency between the two groups,it was found that the improvement values at each frequency in the experimental group were higher than those in the control group,and there were significant differences at the two frequencies of 250 Hz and 500 Hz(P < 0.05).No complicationssuch as tympanic membrane perforation or ear infection occurred throughout the treatment and during late follow-up either in experimental or in control group.Conclusions:Dexamethasone combined with hyaluronic acid gel tympanic injection may be more effective than dexamethasone alone in the treatment of patients with severe-to-profound sudden sensorineural hearing ioss,especially in improving low-frequency hearing,and tympanic injection of hormones in the treatment of sudden sensorineural hearing loss is a safe and effective treatment.