The Short-term Clinical Therapeutic Effectiveness Observation Of Intratympanic Joint Vein Dexamethasone And Traditional Treatment For Sudden Sensorineural Hearing Loss

Objective To observe the the short-term clinical therapeuticeffectiveness of intratympanic dexamethasone（ITD）joint veindexamethasone and traditional treatment for sudden sensorineural hearingloss（SSNHL）. Then compare it with the therapeutic effectiveness of veindexamethasone joint traditional treatment.Methods The cases of SSNHL were divided into treatment group1,treatment group 2,control group 1,control group 2 by the charged time.After the treatment agreement was signed,the control group 1 were givenhigh liquid oxygen and dexamethasone,activating blood circulation andeliminating stasis drugs,vitamin and so on by intravenous drip.The controlgroup 2 were given hyperbaric oxygen and dexamethasone,activating bloodcirculation and eliminating stasis drugs,vitamin by intravenous drip.Besidesthe treatment above,ITD was performed on the treatment group 1 and thetreatment group 2. Assessment of hearing level was carried out on the day orthe second day when ITD was over and when one course of 10 days of othertreatments ended. Record the results and caculate the puretone average （PTA）of 500 HZ, 1 KHZ, 2 KHZ, 4 KHZ.Compare the PTA before andafter the treatments, and the records of 250 HZ and 8 KHZ were alsocompared as above. Hearing improvement was defined as a 15 dBHLdecrease, compare the effective rates of the four groups and observe thecomplications ITD .Results The PTA of the treatment group 1 is（92.09±25.89）dBHL atthe time of admission,and is（66.36±24.67）dBHL after the treatment.Thetreatment group 1 got an average improvement of（25.73±6.07）dBHL（P<0.01）.the PTAof the treatment group 2 is（75.54±19.14）dBHL at thetime of admission,and is（51.38±24.36）dBHL after the treatment.Thetreatment group 2 got an average improvement of（24.15±4.86）dBHL（P<0.01）.The PTA of the control group 1 is（84.45±19.78）dBHL at thetime of admission,and is（68.09±23.14）dBHL after the treatment. Thecontrol group 1 got an average improvement of（16.36±3.36）dBHL（P<0.01）.The PTAof the control group 2 is（73.84±18.55）dBHL at thetime of admission,and is（54.38±20.96）dBHL after the treatment.Thecontrol group 2 got an average improvement of（19.46±6.01）dBHL（P<0.01）.The PTA of four groups before and after the treatment havestatistical significance differences.The puretone threshold of 250HZ of thetreatment group 1 got an average improvement of（32.14±27.51）dBHL （P>0.01）.The puretone threshold of 250HZ of the treatment group 2 got anaverage improvement of（31.36±15.35）dBHL（P<0.01）.The puretonethreshold of 250HZ of the control group 1 got an average improvement of（41.11±26.07）dBHL（P<0.01）.The puretone threshold of 250HZ of thecontrol group 2 got an average improvement of（25.56±21.28）dBHL（P<0.01）.Except for the treatment group 1,the puretone threshold of all thethree groups before and after treatment of 250HZ have statistical significancedifferences.The puretone threshold of 8KHZ of the treatment group 1 got anaverage improvement of（7.50±16.47）dBHL（P>0.01）.The puretonethreshold of 8KHZ of the treatment group 2 got an average improvement of（21.82±9.82）dBHL（P<0.01）.The puretonethreshold of 8KHZ of thecontrol group 1 got an average improvement of（28.33±27.50）dBHL（P>0.01）.The puretone threshold of 8KHZ of the control group 2 got anaverage improvement of（22.78±21.52）dBHL（P>0.01）. Except for thetreatment group 2,the puretone threshold of all the three groups before andafter treatment of 8KHZ have no statistical significance differences. Therewas no statistical significance differences between the treatment group 1 andthe control group 1,or treatment group 2 and the control group 2 of 250HZ aswell as 8KHZ（P>0.01）.Overall improvement was observed in 9 ears（81.8%）of the treatment group 1 and 4 ears（36.4%）of the control group 1, effective rate of the two groups have statistically significant difference（P<0.05）.Overall improvement were observed in 8 ears（61.5%）of thetreatment group 2 and 5 ears（38.5%）of the control group 2.Effective ratesof the two groups have no statistically significant difference（P>0.05）.Therewere no middle ear infection of 22 patients（24ears）, the treatment is invalidfor 1 case,but her hearing level haven’t continue to fall. In the process ofinjection,5 cases occurred vertigo, 2 cases of the treatment group gottemporary mild edema,all of the 20 patients did not appear systemic adversereactions.Conclusion First, four kinds of the treatments are valid.Maybe,theclinical therapeutic effectiveness of intratympanic dexamethasone joint veindexamethasone and traditional treatment for sudden sensorineural hearingloss is more effective than that of vein dexamethasone joint traditionaltreatment. But it is not effect for all the patients.Second,hearing curativeeffect of low frequency is better than high frequency.The two treatmentstrategies have no obvious difference for the improvement of low or highfrequency hearing leavel.Third,The ITD therapeutic schedule of 2.5 mg oncea day for continuous 5 days joint vein dexamethasone and traditionaltreatment can arrive at high effective rate. 5.The therapeutic schedule ofintratympanic dexamethasone joint vein dexamethasone and traditional treatment is safe and easy to operate, and its high patient compliance ishelpful for its clinical promotion.