[Efficacy of high dose glucocorticoid in the salvage treatment of sudden deafness].

Objective

To observe the efficacy and safety of high dose dexamethasone injection in the tympanic cavity in the patients with sudden and severe deafness who failed conventional treatment. Method:A total of 43 patients with unilateral sudden and severe deafness were recruited in this study. All patients were not cured with conventional comprehensive treatment in the department of otology. They were divided into two groups: 21cases were treated with high dose dexamethasone injection into the tympanic cavity by ventilation tube （dexamethasone group）, while routine treatment was continued in 22 cases （conventional control group）. Each patient underwent a hearing test before treatment, the hearing thresholds of 6 frequencies （0.25, 0.5, 1.0, 2.0, 4.0, 8.0 kHz） were recorded. After one week of treatment, the above-mentioned six frequencies were re-recorded. A decrease of the pure tone threshold average （PTA） more than 15 dB was set for effective. Result:After 1 week treatment, comparison of the PTA value before and after treatment in dexamethasone group（t=11.749） and in conventional control group （t=7.364），comparison of the PTA value of the two groups （t=-2.628），comparison of the PTA value of hearing improvement between the two groups （t=2.717）,the differences were statistically significant（P<0.01 or 0.05）. Sixteen cases in dexamethasone group were effective, the effective rate was 76.2%;10 cases in conventional control group was effective, the effective rate was 45.5%,the difference of the two curative effects was statistically significant（χ²=3.058,P<0.05）. Eighteen patients in dexamethasone group had vertigo before treatment. The patients were followed up for 6 months after treatment. The vertigo disappeared or decreased in 14 cases, the improve rate is 77.8%.17 patients in the conventional control group had vertigo before treatment, the patients were followed up for 6 months after treatment, the vertigo disappeared or decreased in 6 cases, the improve rate is 35.3%,the difference was statistically significant（P=0.018）.

Conclusion

High dose dexamethasone injection into the tympanic cavity is more effective than conventional therapy in the salvage treatment of sudden and severe deafness, and it is helpful to improve vertigo.