The Effects Of Postauricuar Injection Of Methylprednisolone On Medium-high Frequency Sudden Hearing Loss

The cause of sudden deafness is unclear,and many factors may lead to sudden hearing loss.With the increasing of people's spirit,life pressure and working rhythm,the incidence of sudden deafness is increasing year by year.A lot of researches have been done on the treatment of sudden deafness at home and abroad.Glucocorticoid is considered to be the most effective drug in the treatment of sudden deafness.There is no uniform treatment standard in drug selection.When systemic glucocorticoid is used to treat sudden deafness,it is necessary to prolong the time of hormone use and / or increase the dosage of hormone.In orderto make the hormone in the human ear to achieve effective drug concentration,accompanied by diabetes,hypertension and other diseases in the use of systemic hormone may lead to the appearance of exacerbation of the disease[1].There is no uniform treatment standard in drug selection.Previous studies have shown that retroauricular injection is higher in both the maintenance time of effective drug concentration and the concentration to the inner ear than the systemic use of hormones.However,the drug concentration in systemic circulation is very low,and the feasibility and safety have been demonstrated again[2].This article mainly describes the therapeutic effect of intraauricular injection of methylprednisolone in the treatment of sudden hearing loss of middle and high frequency hearing loss.Sudden deafness cases were collected from the Department of Otorhinolaryngology and head and neck surgery in the first affiliated Hospital of Hebei North University during the period of 2015.09-2017.09.After 3 days of onset and 14 days of treatment,45 ears of patients with middle and high frequency hearing loss were selected.The selection criteria are: In accordance with the diagnostic and therapeutic guidelines developed by the Chinese Medical Association Otolaryngology head and neck surgery Society in 2015[3];According to the standard classification of sudden deafness proposed by the national multicenter study,the patients with intermediate and high frequency hearing loss were selected as ineffective after two courses of treatment for 14 days[4].The treatment time of exclusion standard: Is short,not more than 7 days;Suffering from systemic diseases such as hypertension,digestive system ulcer,diabetes mellitus,pregnant women,acoustic neuroma,large vestibular aqueduct syndrome and other hereditary deafness.All the data were analyzed by SPSS 22.0 statistical software.The effective rate of routine treatment group and retroauricular injection group was compared with ?2 test.There was significant difference between the two groups by t test(P < 0.05).The improvements for the non-postauricular injection group were 6.30±5.00 d B HL,3.80±5.52 d B HL,5.35±5.50 d B HL,15.60±11.84 d B HL,19.60±13.46 d B HL,15.40±12.90 d B HL at,250,500,1000,2000,4000 and 8000 Hz,respectively.The hearing improvements for the postauricular injection group were 5.35±6.22 d B HL,2.50±3.00 d B HL,4.65±6.60 d B HL,23.75±10.75 d B HL,25.75±11.73 d B HL,30.50±14.50 d B HL at 250,500,1000,2000,4000 and 8000 Hz,respectively.There were significant differences between the two groups in hearing improvements at 2000 Hz~8000Hz.There was asignificant difference between the two groups in the 2000~8000 Hz hearing improvement,and the difference was statistically significant(P<0.05).The treatment effective rates were 44% and 80% for the non-postauricular injection group and postauricular injection group respectively,showing a significant difference(?2=8.385,P=0.039<0.05).In recent years,some scholars have discovered the characteristics of microcosmic blood circulation behind the ear and the inner ear bystudying the anatomical structure of the ear.As a result,local useof hormone began to attract people's attention.Local use of hormone mainly includes intratympanic administration and retroauricular injection.Compared with intratympanic injection,retroauricular injection is simple,less complications and cheaper.It is easy to be popularized in clinical practice.This article reviews the efficacy of retroauricular injection of methylenolone as a rescue regimen in the treatment of medium-high frequency hearing loss sudden deafness.The effectivenessof retroauricular injection in the treatment of sudden deafness was further proved.