| Objective:To compare the effect of subperiosteal local injection of corticosteroids in the masto-id area with systemic administration of corticosteroids for the treatment of flat type and total deafness type of sudden deafness, in order to provide new ideas for treating this disease.Methods:This study included 108 patients with sudden hearing loss of flat type or total deafness type. The patients were hospitalized in the Second Hospital of Shanxi Medical University and didn’t receive any treatment before admission. Their ages ranged from18 to 65 years old. The patients of each group(i.e. flat type group and total deafness group) were then divided into two subgroups: systemic steroid subgroup(intravenous injection of dexamethasone, 10 mg/d for the first 3 days, 5 mg/d for the second 3 days, and 2.5mg/d for the last 3 days) and local injection subgroup(local injection in the mastoid area with mixture of methylprednisolone sodium succinate 40 mg and lidocaine 0.2ml, once every three days for 15 days). All therapeutic measures but administration routes of glucocorticoid were the same in all the patients. The course of treatment lasted until recovery of hearing(less than 2 weeks) or for 15 days. All data were processed by SPSS 22.0. Statistical analyses of therapeutic effect were performed using simple descriptions and frequencies of various factors, chi-squared test, independent samples t-test, Spearman correlation analysis. Results:108 patients meeting the inclusion criteria were collected. According to the audiometric curve type, they were divided into flat type group(n=61) and total deafness group(n=47). In the flat type group, 30 and 31 cases were enrolled into systemic steroid subgroup and local injection subgroup respectively. The patients of systemic steroid subgroup aged from 18 to 65 years old with an average of(47.23 ±12.76). Of them, 16 were male(53.3%) and 14 were female(46.7%). Left ear was involved in 15 cases(50%) and right in the other 15(50%). After treatment, 10 cases(33.3%) were cured, 5(16.7%) had marked effect, 7(23.3%) had effect, 8 cases(26.7%) were invalid, and the total effective rate was 73.3%(22/30). The cases in local injection subgroup aged from 19 to 65 years old with an average of(46.16± 12.15). As for their gender, 15(48.4%) were male and 16(51.6%) were female. Left ear was involved in 14(45.16%) and right in 17(54.84%). 9(29%) cases were cured, 4(12.9%) got marked effect, 7(22.6%) were effective, 11(35.5%) were invalid. The total effective rate was 64.5%(20/31). Statistic analyses showed insignificant differences in patients’ gender, age and sides of involved ears between both subgroups. And also their differences of total effective rate and curative effect were statistically insignificant(2c =0.553, P=0.457>0.05; P=0.495>0.05 respectively).In total deafness group, 22 cases were allocated to systemic steroid subgroup, age ranging from 21 to 65 years old with an average of(46.77 ± 12.87). 13(59.1%) were male and 9(40.9%) were female. Left ear was involved in 9(40.9%) and right ear in 13(59.1%). 3 cases were cured(13.6%), 8 were excellent(36.4%), 5(22.7%) effective, 6(27.3%) invalid, with a total effective rate of 72.7%(16/22). 25 cases were included in the local injection subgroup. Their age range was from 20 to 64 years old, with an average of(46.8 ±11.36). Of them, 11(44%) were male, 14(56%) were female. Deafness occurred in left ear of 11 cases(44%), right ear of 14(56%). After treatment, 3 cases(12%) were cured, 8(32%) had marked effect, 6(24%) had effect, 8(32%) were invalid, and the total effective rate was 68%(17/25). The differences in patients’ gender, age and sides of involved ears between the two subgroups were statistically insignificant. And statistic analyses also showed insignificant differences of total effective rate and curative effect(2c =0.125, P=0.724>0.05; P=0.681>0.05). Conclusion:For sudden hearing loss of flat type or total deafness type, the differences in cure rate between subperiosteal local injection in mastoid area and systemic administration of glucocorticoid are insignificant. Taking into account the side effects of systemic hormone application, it is recommended that subperiosteal local injection in mastoid area should be preferred. |
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