Postauricular Injection Of Glucocorticoid Therapy For The All-frequency Sudden Sensorineural Hearing Loss

Objective:To observe the effects of postauricular injection of glucocorticoid in the treatment of the all-frequency sudden sensorineural hearing loss(SSNHL),and explore the clinical application of postauricular injection of glucocorticoid in SSNHL.Methods:Through a prospective controlled study,we collected SSNHL patients of Longgang Otorhinolaryngology hospital from July 2015 to June 2016,a total of 66 patients between 18 to 60 years old were collected,including 40 males and 26 females,the average age was 39 years old.There were 37 cases in left ear and 29 cases in right ear.Treatment delay was 1 to 14 days,with an average of 6 days,and then divided them into two groups randomly by admission sequence.The postauricular therapy(PT)group was treated with postauricular injection of methylprednisolone 40 mg qd,for 5days;the intravenous therapy(IT)group was treated with intravenous infusion of methylprednisolone 40 mg qd,for 5 days.Other treatments were identical and the treatment efficacy was compared between the two groups after 10 days of treatment.SPSS 18.0 was used for statistical analysis.Results:1.Hearing loss:(1)The effective rate was 71.42%(25/35)and 77.41%(24/31)respectively in the PT group and IT group.There was no significant difference between the two groups(P > 0.05).The average hearing threshold after treatment was55.10±26.92 dB HL and 41.12±23.56 dB HL respectively in the PT group and IT group,there was significant difference between the two groups(P < 0.05).(2)Patients with the two different therapies were placed in the same factor groups of hearing loss degree,age stage,course or accompanied symptoms to make the average hearing threshold comparison,and the results showed: except the accompanied by dizziness group,the average hearing threshold improvement of the intravenoustherapy was better than the postauricular therapy in other factors groups,there was significant difference between the two therapies in the severe and profound hearing loss group and the course of ? 7 days group(P < 0.05).2.Tinnitus: Tinnitus was detected in 90.91%(60/66)cases.The effective rate was 77.41%(24/31)and 75.86%(22/29)respectively in the PT group and IT group.There was no significant difference between the two groups(P > 0.05).3.Dizziness: Dizziness was detected in 18.18%(12/66)cases,including six cases of normal vestibular function,six cases of abnormal vestibular function,and two cases of abnormal vestibular function with BPPV.Through 10 days of treatment,the dizziness with six cases in the PT group or IT group,were well controlled.Conclusion:1.The postauricular injection of glucocorticoid as initial treatment for the all-frequency SSNHL is effective for hearing loss,but the average hearing threshold improvement is less than the intravenous infusion;it can improve the symptoms of tinnitus,but without obvious advantages;it does not show treatment differences in the dizziness control from the intravenous infusion.2.For patients without systemic contraindications,intravenous administration of glucocorticoids is still recommended as the initial treatment,especially for the patients with severe and profound hearing loss or with the course of ? 7 days.