| Objective:In order to find a simple,safe,effective and convenient method for the treatment of fully-deafness sudden hearing loss,three different methods of dexamethasone were used to treat the sudden hearing loss.Methods:From October 2016 to January 2018,102 patients?49 males and 52females?with sudden deafness were diagnosed in the Department of Otorhinolaryngology,affiliated Hospital of Yan'an University.These patients are from 18to 65 years old,with 57 cases of left ear and 45 cases of right ear.Patients with sudden hearing loss were randomly divided into three groups.The group were given 10mg of dexamethasone and stopped after 5 days.Group B given the drum room with the injection of dexamethasone 5mg,the next day,five times.Group C gave the ear to dexamethasone 5mg,the next day,five times.Give more than in the same way lower fibrinogen drugs?urokinase?and improve microcirculation?with front row place dry emulsion injection?treatment,2 weeks after treatment to observe,record and analysis of three groups of patients,listening to improve treatment effect and adverse reaction,etc.After treatment,2 weeks and 3 months after treatment,the audiometry was recorded.Efficacy criteria[1]:?1?Healing:The frequency of hearing loss returned to normal,or to the level of the ear,or to the level before the illness.?2?Excellence:Hearing loss frequency increased by 30 dB or more on average?3?Effective:The average hearing loss frequency is increased by 1530dB?4?Invalid:The average improvement in hearing loss frequency is less than 15 dB.Results:1.Post treatment effect:Three groups of patients with sudden hearing loss were treated with different methods of administration.A group before treatment,the average hearing threshold of 96.37±11.52 dBHL after treatment,the average hearing threshold of71.80±25.39 dBHL;B group before treatment,the average hearing threshold of97.53±12.84 dBHL,after treatment,the average hearing threshold of 71.89±26.65dBHL;C group before treatment,the average hearing threshold was 96.03±10.59dBHL,after treatment,the average hearing threshold of 70.30±23.35dBHL.Compared with the average hearing threshold before and after treatment,the difference was statistically significant?P=0.000<0.05?,and dexamethasone was considered as intravenous drip.Tympanic injection and retroauricular injection were effective as initial treatment for fully-deafness Sudden hearing loss.2.Hearing gain after treatment:Hearing improvement of group A 24.07±33.11dBHL after treatment;Hearing improvement of group B 18.86±25.43 dBHL after treatment;HearingimprovementofgroupC18.07±31.37dBHLafter treatment.Compared with the three groups after treatment,the difference was not statistically significant?P=0.924>0.05?,It can be concluded that there is no significant difference in hearing gain in the treatment of fully-deafness Sudden hearing loss intravenous infusion of dexamethasone,tympanic injection.3.Hearing gain after treatment:The effective rate of group A was 60.00%?18/30?,the effective rate of group B was 62.86%?22/35?,the effective rate of group B was 62.16%?23/37?.The effective rates of the three groups were compared,and the difference was not statistically significant?P=0.971>0.05?.It was concluded that there was no significant difference in the effective rate of dexamethasone intravenous drip,tympanic cavity injection and retroauricular injection after treatment of fully-deafness Sudden hearing loss.4.After treatment,the distribution of curative effect was different:In group A,3people were cured,7 Excellence,8 effective,12 invalid;In group B,4 people were cured,8 Excellence,10 effective,13 invalid,In group C,4 people were cured,9 Excellence,10effective,14 invalid.There was no significant difference in the distribution of therapeutic effects among the three groups after intravenous infusion of dexamethasone,intratympanic injection and retroauricular injection.There was no significant difference in the distribution of therapeutic effects between the three groups after treatment of fully-deafness Sudden hearing loss.5.Changes of hearing threshold gain at different frequencies after treatment:The frequency in A group after treatment?250Hz,500Hz,between 1000Hz,2000Hz,3000hz,4000Hz,8000Hz?threshold value change,by statistical analysis,the difference was not statistically significant?P=0.715>0.05?;After treatment,there was no significant difference in the change of hearing threshold between different frequencies in group B,and the difference was not statistically significant?P=0.293>0.05?.After treatment,there was no significant?P=0.792>0.05?difference in the change of hearing threshold between different frequencies in group C,and the difference was not statistically significant.It can be concluded that there is no significant difference in the changes of hearing threshold at different frequencies after intravenous infusion of dexamethasone,tympanic injection and retroauricular injection in the treatment of fully-deafness Sudden hearing loss.6.The effect of tinnitus on the treatment of fully-deafness Sudden hearing loss patients with total deafness:Among 102 patients with fully-deafness Sudden hearing loss,82 cases?80.39%?were associated with tinnitus,20 cases without tinnitus?19.61%?,50cases with tinnitus and effective patients?60.98%?,and 12 cases with tinnitus without tinnitus?60.00%?.The statistical analysis showed that there was no significant difference between the two groups in the treatment of fully-deafness Sudden hearing loss with tinnitus,that is to say,there was no significant effect on the treatment of sudden deafness with tinnitus.7.Safety and stability of treatment:The incidence of adverse reactions in group A was 6.67%?2/30?,The incidence of adverse reactions in group B was 2.86%?1/35?,The incidence of adverse reactions in group C was 2.70%?1/37?.The three groups of adverse reactions were gastric discomfort,transient vertigo and intense pain in the post ear injection site,all of these symptoms improved obviously after treatment.There was no significant irreversible adverse reaction in this experimental study,so the three groups were safe and reliable.Comparison of the mean hearing threshold between follow-up and treatment for 2 weeks after 3 months,by statistical analysis,the difference was not statistically significant.It can be concluded that there is no significant difference between the hearing of the patients followed up 3 months later and that of 2 weeks after treatment,that is to say,the curative effect of the three groups is stable.Conclusion:1.Tympanic cavity injection and retroauricular injection were all effective in the treatment of fully-deafness Sudden hearing loss,and there was no significant difference in the effective rate,the distribution of curative effect,and the level of hearing improvement.There was no significant difference in the change of hearing threshold between different frequencies.2.The effect of tinnitus on the treatment of fully-deafness Sudden hearing loss was not obvious.3.Tympanic injection and retroauricular injection of dexamethasone can be used as the initial treatment for all sudden hearing loss,which is safe and stable.Especially for the patients with systemic hormone use contraindication,the dosage of local administration is small,It can not only avoid the complications of systemic hormone use,but also be cheap and easy to operate,so it can be popularized. |
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