早期联合口服与鼓室内皮质类固醇治疗对突发性感音神经性听力损失听力结局的影响：一项前瞻性队列研究。

文献信息

中文摘要

目的： 评估突发性感音神经性听力损失（SSHL）患者早期同时接受口服与鼓室内皮质类固醇治疗后的听力结局。
方法： 开展了一项前瞻性队列研究，纳入65例接受口服泼尼松（1 mg/kg/天；最大60 mg/天）治疗14天联合鼓室内甲泼尼龙（40 mg/mL）每周给药、持续三周的成年SSHL患者。主要结局为基线与治疗一个月后纯音平均听阈（PTA；500-3000 Hz）和言语识别率（SDS）的变化。
结果： 中位基线PTA从85 dB改善至治疗一个月后的56 dB，对应中位改善28 dB（p < 0.0001）。中位SDS从0%提高至80%（p < 0.0001）。根据治疗开始时间、年龄组或基线听力分类，未观察到听力改善方面有统计学显著差异。
结论： 在这组SSHL患者中，早期同时联合口服与鼓室内皮质类固醇治疗与PTA和SDS的显著改善相关，随访期间未观察到重大不良事件。需要进一步的比较研究以更好地明确早期联合治疗在SSHL管理中的作用。

英文摘要

OBJECTIVE: To evaluate hearing outcomes following early simultaneous oral and intratympanic corticosteroid therapy in patients with sudden sensorineural hearing loss (SSHL).
METHODS: A prospective cohort study was conducted including 65 adult patients with SSHL treated with oral prednisone (1 mg/kg/day; maximum 60 mg/day) for 14 days combined with intratympanic methylprednisolone (40 mg/mL) administered weekly for three weeks. The primary outcomes were changes in pure-tone average (PTA; 500-3000 Hz) and speech discrimination score (SDS) at baseline and one month after treatment.
RESULTS: Median baseline PTA improved from 85 dB to 56 dB one month after treatment, corresponding to a median improvement of 28 dB (p < 0.0001). Median SDS increased from 0% to 80% (p < 0.0001). No statistically significant differences in hearing improvement were observed according to treatment initiation time, age group, or baseline hearing classification.
CONCLUSION: Early simultaneous combined oral and intratympanic corticosteroid therapy was associated with significant improvements in PTA and SDS in this cohort of patients with SSHL without major adverse events observed during follow-up. Further comparative studies are required to better define the role of early combined therapy in SSHL management.